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Ghasemian R, Vahedi Larijani L, Rasouli K, Hedayati MT, Tavakol C, Heydari K, Zalpoor H, Hoseini A. Renal aspergillosis after COVID-19-associated pulmonary aspergillosis: A case report. Clin Case Rep 2023; 11:e7882. [PMID: 37692155 PMCID: PMC10485246 DOI: 10.1002/ccr3.7882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/12/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023] Open
Abstract
Key Clinical Message Renal aspergillosis is a rare condition and this case the first case of Renal aspergillosis reported after COVID-19-associated pulmonary aspergillosis. Renal symptoms should arise clinical suspicion to renal involvement that happened as a result of hematogenous spreading of pulmonary aspergillosis. Abstract Secondary fungal infections are among the most significant complications that can arise after COVID-19 and have the potential to lead to a high rate of morbidity and mortality. As COVID-19 primarily involves the airway, the majority of fungal infections reported have been related to the respiratory system. However, renal aspergillosis that we have reported is a rare condition that also can occur. A 67-year-old man was referred to our hospital and admitted as a COVID-19 patient. After the initial recovery, he experienced a recurrence of fever accompanied by a productive cough. The histopathological studies were conducted on the sputum and bronchoalveolar lavage samples, which revealed the presence of Aspergillus flavus. We treated the patient with voriconazole and the patient was discharged after a period of time. However, after approximately 6 months, he returned to the hospital with a fever and abdominal pain. We started a fever workup. Two new hypoechoic abscess-like masses were spotted in the right kidney in the ultrasonography (U/S) and the direct molecular studies of the biopsy sample obtained under U/S guidance identified Aspergillus flavus. Although renal aspergillosis is a rare condition, it should not be overlooked, especially in patients with severe COVID-19 and pulmonary aspergillosis, as these conditions can lead to renal aspergillosis, which may present with symptoms such as abdominal pain with fever. Therefore, it is necessary to perform radiological and histopathological studies when renal aspergillosis is suspected.
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Affiliation(s)
- Roya Ghasemian
- Department of Infectious DiseaseAntimicrobial Resistance Research Center, Mazandaran University of Medical SciencesSariIran
| | - Lale Vahedi Larijani
- Department of Pathology, School of MedicineMazandaran University of Medical SciencesSariIran
- Gastrointestinal Cancer Research Center, Non‐Communicable Diseases Institute, Mazandaran University of Medical SciencesSariIran
| | - Kimia Rasouli
- Student Research Committee, School of MedicineMazandaran University of Medical SciencesSariIran
| | - Mohammad Taghi Hedayati
- Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariIran
- Invasive Fungi Research Center/Department of Medical Mycology, School of MedicineMazandaran University of Medical SciencesSariIran
| | - Chanour Tavakol
- Tehran School of MedicineTehran University of Medical SciencesTehranIran
| | - Keyvan Heydari
- Gastrointestinal Cancer Research Center, Non‐Communicable Diseases Institute, Mazandaran University of Medical SciencesSariIran
- Student Research Committee, School of MedicineMazandaran University of Medical SciencesSariIran
| | - Hamidreza Zalpoor
- Shiraz Neuroscience Research Center, Shiraz University of Medical SciencesShirazIran
- Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN)TehranIran
- American Association of Kidney Patients (AAKP)TampaFloridaUSA
| | - Aref Hoseini
- Student Research Committee, School of MedicineMazandaran University of Medical SciencesSariIran
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Sedighi F, Zarghami M, Alizadeh Arimi F, Moosazadeh M, Ala S, Ghasemian R, Mehravaran H, Elyasi F. Efficacy and safety of adding fluoxetine to the treatment regimen of hospitalized patients with non-critical COVID-19 pneumonia: A double-blind randomized, placebo-controlled clinical trial. Neuropsychopharmacol Rep 2023; 43:202-212. [PMID: 36941089 PMCID: PMC10275279 DOI: 10.1002/npr2.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/27/2023] [Accepted: 02/21/2023] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION Selective serotonin reuptake inhibitors are considered the drugs, whose effectiveness in viral pandemics has been studied. The aim of this study was to evaluate of adding fluoxetine to the treatment regimen of patients with COVID-19 pneumonia. METHODS This study was a double-blind randomized placebo controlled clinical trial .36 patients in the fluoxetine and 36 patients in the placebo group were enrolled. Patients in the intervention group were first treated with fluoxetine 10 mg for 4 days and then the dose of 20 mg was continued for 4 weeks. Data analysis was conducted using SPSS V. 22.0. RESULTS There was no statistically significant difference between the two groups in terms of clinical symptoms at the beginning of the study and also the score of anxiety and depression, oxygen saturation at the time of hospitalization, mid-hospitalization and discharge periods. The need for mechanical ventilator support (p = 1.00), the need for admission in the intensive care unit (ICU) (p = 1.00), rate for mortality (p = 1.00), and discharge with relative recovery (p = 1.00) were not significantly different between the two groups. The distribution of CRP within the study groups showed a significant decrease during different time periods (p = 0.001), and although there was no statistically significant difference between the two groups on the first day (p = 1.00) and at discharge (p = 0.585), mid-hospital CRP showed a significant decrease in the fluoxetine group (p = 0.032). CONCLUSION Fluoxetine resulted in a faster reduction of patients' inflammation without association with depression and anxiety.
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Affiliation(s)
- Faranak Sedighi
- Psychiatry and Behavioral Sciences Research CenterAddiction InstituteMazandaran University of Medical SciencesSariIran
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research CenterAddiction InstituteMazandaran University of Medical SciencesSariIran
- Department of PsychiatryFaculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Fatemeh Alizadeh Arimi
- Psychiatry and Behavioral Sciences Research CenterAddiction InstituteMazandaran University of Medical SciencesSariIran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research CenterNon‐communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Shahram Ala
- Department of Clinical PharmacyPharmaceutical Sciences Research CenterHemoglobinopathy Institute, Faculty of PharmacyMazandaran University of Medical SciencesSariIran
| | - Roya Ghasemian
- Antimicrobial Resistance Research CenterDepartment of Infectious DiseasesMazandaran University of Medical SciencesSariIran
| | - Hossein Mehravaran
- Department of Internal MedicinePulmonary and Critical Care DivisionFaculty of MedicineMazandaran University of Medical SciencesSariIran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research CenterAddiction InstituteMazandaran University of Medical SciencesSariIran
- Department of PsychiatryFaculty of MedicineMazandaran University of Medical SciencesSariIran
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Samaee HR, Eslami G, Rahimzadeh G, Saeedi M, Davoudi Badabi A, Asare-Addo K, Nokhodchi A, Roozbeh F, Moosazadeh M, Ghasemian R, Alikhani A, Rezai MS. Inhalation phage therapy as a new approach to preventing secondary bacterial pneumonia in patients with moderate to severe COVID-19: A double-blind clinical trial study. J Drug Deliv Sci Technol 2023; 84:104486. [PMID: 37123173 PMCID: PMC10116154 DOI: 10.1016/j.jddst.2023.104486] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/10/2023] [Accepted: 04/18/2023] [Indexed: 05/02/2023]
Abstract
Inhalation phage therapy is proposed as a replacement approach for antibiotics in the treatment of pulmonary bacterial infections. This study investigates phage therapy on bacterial pneumonia in patients with moderate to severe COVID-19 via the inhalation route. In this double-blind clinical trial, 60 patients with positive COVID-19 hospitalized in three central Mazandaran hospitals were chosen and randomly divided into two intervention and control groups. Standard country protocol drugs plus 10 mL of phage suspension every 12 h with a mesh nebulizer was prescribed for 7 days in the intervention group. The two groups were compared in terms of O2Sat, survival rate, severe secondary pulmonary bacterial infection and duration of hospitalization. Comparing the results between the intervention and control group, in terms of the trend of O2Sat change, negative sputum culture, no fever, no dyspnea, duration of hospitalization, duration of intubation and under ventilation, showed that the difference between these two groups was statistically different (P value < 0.05). In conclusion, inhalation phage therapy may have a potential effect on secondary infection and in the outcome of COVID-19 patients. However, more clinical trials with control confounding factors are needed to further support this concept.
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Affiliation(s)
- Hamid Reza Samaee
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gohar Eslami
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Golnar Rahimzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Davoudi Badabi
- Antimicrobial Resistance Research Center and Communicable Diseases Institute, Department of Infectious Diseases, Ghaem Shahr Razi Hospital, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kofi Asare-Addo
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Ali Nokhodchi
- Pharmaceutics Research Lab, School of Life Sciences, University of Sussex, Brighton, UK
| | - Fatemeh Roozbeh
- Department of Infectious Diseases, Boo Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Alikhani
- Antimicrobial Resistance Research Center and Communicable Diseases Institute, Department of Infectious Diseases, Ghaem Shahr Razi Hospital, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Mostafavi E, Eybpoosh S, Karamouzian M, Khalili M, Haji-Maghsoudi S, Salehi-Vaziri M, Khamesipour A, Jalali T, Nakhaeizadeh M, Sharifi H, Mansoori Y, Keramat F, Ghodrati S, Javanian M, Doroud D, Omrani MD, Asadi H, Pouriayevali MH, Ghasemian R, Farshidi H, Pourahmad M, Ghasemzadeh I, Mounesan L, Darvishian M, Mirjalili MR, Toledo-Romani ME, Valenzuela-Silva C, Verez-Bencomo V, Gouya MM, Emadi-Koochak H, Haghdoost AA, Biglari A. Efficacy and Safety of a Protein-Based SARS-CoV-2 Vaccine: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2310302. [PMID: 37133864 PMCID: PMC10157429 DOI: 10.1001/jamanetworkopen.2023.10302] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Importance The protein-based SARS-CoV-2 vaccines FINLAY-FR-2 (Soberana 02) and FINLAY-FR-1A (Soberana Plus) showed good safety and immunogenicity in phase 1 and 2 trials, but the clinical efficacy of the vaccine remains unknown. Objective To evaluate the efficacy and safety of a 2-dose regimen of FINLAY-FR-2 (cohort 1) and a 3-dose regimen of FINLAY-FR-2 with FINLAY-FR-1A (cohort 2) in Iranian adults. Design, Setting, and Participants A multicenter, randomized, double-blind, placebo-controlled, phase 3 trial was conducted at 6 cities in cohort 1 and 2 cities in cohort 2. Participants included individuals aged 18 to 80 years without uncontrolled comorbidities, coagulation disorders, pregnancy or breastfeeding, recent immunoglobulin or immunosuppressive therapy, and clinical presentation or laboratory-confirmed COVID-19 on enrollment. The study was conducted from April 26 to September 25, 2021. Interventions In cohort 1, 2 doses of FINLAY-FR-2 (n = 13 857) or placebo (n = 3462) were administered 28 days apart. In cohort 2, 2 doses of FINLAY-FR-2 plus 1 dose of FINLAY-FR-1A (n = 4340) or 3 placebo doses (n = 1081) were administered 28 days apart. Vaccinations were administered via intramuscular injection. Main Outcomes and Measures The primary outcome was polymerase chain reaction-confirmed symptomatic COVID-19 infection at least 14 days after vaccination completion. Other outcomes were adverse events and severe COVID-19. Intention-to-treat analysis was performed. Results In cohort 1 a total 17 319 individuals received 2 doses and in cohort 2 5521 received 3 doses of the vaccine or placebo. Cohort 1 comprised 60.1% men in the vaccine group and 59.1% men in the placebo group; cohort 2 included 59.8% men in the vaccine group and 59.9% in the placebo group. The mean (SD) age was 39.3 (11.9) years in cohort 1 and 39.7 (12.0) years in cohort 2, with no significant difference between the vaccine and placebo groups. The median follow-up time in cohort 1 was 100 (IQR, 96-106) days and, in cohort 2, 142 (137-148) days. In cohort 1, 461 (3.2%) cases of COVID-19 occurred in the vaccine group and 221 (6.1%) in the placebo group (vaccine efficacy: 49.7%; 95% CI, 40.8%-57.3%) vs 75 (1.6%) and 51 (4.3%) in cohort 2 (vaccine efficacy: 64.9%; 95% CI, 49.7%-59.5%). The incidence of serious adverse events was lower than 0.1%, with no vaccine-related deaths. Conclusions and Relevance In this multicenter, randomized, double-blind, placebo-controlled, phase 3 trial of the efficacy and safety of FINLAY-FR-2 and FINLAY-FR-1A, 2 doses of FINLAY-FR-2 plus the third dose of FINLAY-FR-1A showed acceptable vaccine efficacy against symptomatic COVID-19 as well as COVID-19-related severe infections. Vaccination was generally safe and well tolerated. Therefore, Soberana may have utility as an option for mass vaccination of the population, especially in resource-limited settings, because of its storage condition and affordable price. Trial Registration isrctn.org Identifier: IRCT20210303050558N1.
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Affiliation(s)
- Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- School of Public Health, Brown University, Providence, Rhode Island
- Centre on Drug Policy Evaluation, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Malahat Khalili
- The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Saiedeh Haji-Maghsoudi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahmineh Jalali
- COVID-19 National Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Mehran Nakhaeizadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Fariba Keramat
- Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samad Ghodrati
- Internal Medicine Department, Zanjan University of Medical Sciences, Zanjan, Iran
- Zanjan Metabolic Diseases Research Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Delaram Doroud
- Quality Control Department, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran
| | - Mir Davood Omrani
- Department of Genetics, School of Medicine, Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Pasteur Institute of Iran, Tehran, Iran
| | - Hassan Asadi
- Pasteur Institute of Iran, Tehran, Iran
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Farshidi
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Morteza Pourahmad
- Department of Infectious Diseases, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Iman Ghasemzadeh
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Mounesan
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Maryam Darvishian
- Cancer Control Research, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| | | | | | | | | | - Mohammad Mehdi Gouya
- Centre for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
- Department of Infectious Disease and Tropical Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Emadi-Koochak
- Department of Infectious Disease, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Biglari
- Pasteur Institute of Iran, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Alizadeh Arimi F, Zarghami M, Moosazadeh M, Mehravaran H, Sedighi F, Ghasemian R, Elyasi F. Frequency of delirium and its associated factors among COVID-19 inpatients in Iran. Clin Respir J 2023; 17:414-428. [PMID: 37054699 DOI: 10.1111/crj.13609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/08/2023] [Accepted: 03/24/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND AND AIM Delirium has been presented as the leading cause of sudden change in the mental state of patients with coronavirus disease 2019 (COVID-19). Given that the delayed diagnosis of such a dysfunction is often associated with excess mortality, it seems essential to devote vastly more attention to this significant clinical characteristic. MATERIALS AND METHODS This cross-sectional study was performed on 309 patients [viz. 259 cases hospitalized in general wards and 50 individuals admitted to the intensive care unit (ICU)]. For this purpose, a Demographic-Clinical Information Questionnaire, the Confusion Assessment Method (CAM), the Confusion Assessment Method for the ICU (CAM-ICU), the Richmond Agitation-Sedation Scale (RASS) and face-to-face interviews were completed by a trained senior psychiatry resident. The data analysis was further done with the SPSS Statistics V22.0 software package. RESULTS Out of 259 patients admitted to the general wards and 50 cases in the ICU due to COVID-19, 41 (15.8%) and 11 (22%) individuals were diagnosed with delirium, respectively. As well, a significant relationship was observed between the incidence rate of delirium and age (p < 0.001), level of education (p < 0.001), hypertension (HTN) (p = 0.029), a history of stroke (p = 0.025), a history of ischemic heart disease (IHD) (p = 0.007), a history of psychiatric disorders, a history of cognitive impairment (p < 0.001), use of hypnotic and antipsychotic medications (p < 0.001) and a history of substance abuse (p = 0.023). Among 52 patients with delirium, only 20 cases had received psychiatric consultation by consultation-liaison psychiatry service for the possibility of delirium. CONCLUSION In view of the high frequency of delirium among COVID-19 inpatients, their screening for this important mental state should be a priority in clinical settings.
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Affiliation(s)
- Fatemeh Alizadeh Arimi
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehran Zarghami
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mehravaran
- Department of Internal Medicine, Pulmonary and Critical Care Division, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Faranak Sedighi
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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6
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Shojaei M, Shamshirian A, Monkman J, Grice L, Tran M, Tan CW, Teo SM, Rodrigues Rossi G, McCulloch TR, Nalos M, Raei M, Razavi A, Ghasemian R, Gheibi M, Roozbeh F, Sly PD, Spann KM, Chew KY, Zhu Y, Xia Y, Wells TJ, Senegaglia AC, Kuniyoshi CL, Franck CL, dos Santos AFR, de Noronha L, Motamen S, Valadan R, Amjadi O, Gogna R, Madan E, Alizadeh-Navaei R, Lamperti L, Zuñiga F, Nova-Lamperti E, Labarca G, Knippenberg B, Herwanto V, Wang Y, Phu A, Chew T, Kwan T, Kim K, Teoh S, Pelaia TM, Kuan WS, Jee Y, Iredell J, O’Byrne K, Fraser JF, Davis MJ, Belz GT, Warkiani ME, Gallo CS, Souza-Fonseca-Guimaraes F, Nguyen Q, Mclean A, Kulasinghe A, Short KR, Tang B. IFI27 transcription is an early predictor for COVID-19 outcomes, a multi-cohort observational study. Front Immunol 2023; 13:1060438. [PMID: 36685600 PMCID: PMC9850159 DOI: 10.3389/fimmu.2022.1060438] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose Robust biomarkers that predict disease outcomes amongst COVID-19 patients are necessary for both patient triage and resource prioritisation. Numerous candidate biomarkers have been proposed for COVID-19. However, at present, there is no consensus on the best diagnostic approach to predict outcomes in infected patients. Moreover, it is not clear whether such tools would apply to other potentially pandemic pathogens and therefore of use as stockpile for future pandemic preparedness. Methods We conducted a multi-cohort observational study to investigate the biology and the prognostic role of interferon alpha-inducible protein 27 (IFI27) in COVID-19 patients. Results We show that IFI27 is expressed in the respiratory tract of COVID-19 patients and elevated IFI27 expression in the lower respiratory tract is associated with the presence of a high viral load. We further demonstrate that the systemic host response, as measured by blood IFI27 expression, is associated with COVID-19 infection. For clinical outcome prediction (e.g., respiratory failure), IFI27 expression displays a high sensitivity (0.95) and specificity (0.83), outperforming other known predictors of COVID-19 outcomes. Furthermore, IFI27 is upregulated in the blood of infected patients in response to other respiratory viruses. For example, in the pandemic H1N1/09 influenza virus infection, IFI27-like genes were highly upregulated in the blood samples of severely infected patients. Conclusion These data suggest that prognostic biomarkers targeting the family of IFI27 genes could potentially supplement conventional diagnostic tools in future virus pandemics, independent of whether such pandemics are caused by a coronavirus, an influenza virus or another as yet-to-be discovered respiratory virus.
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Affiliation(s)
- Maryam Shojaei
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia,Centre for Immunology and Allergy Research, the Westmead Institute for Medical Research, Westmead, NSW, Australia,Department of Medicine, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, NSW, Australia,*Correspondence: Arutha Kulasinghe, ; Kirsty R. Short, ; Maryam Shojaei,
| | - Amir Shamshirian
- Gastrointestinal Cancer Research Centre, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - James Monkman
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Laura Grice
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia,School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Minh Tran
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Chin Wee Tan
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC, Australia,Department of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Siok Min Teo
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Gustavo Rodrigues Rossi
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Timothy R. McCulloch
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Marek Nalos
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
| | - Maedeh Raei
- Gastrointestinal Cancer Research Centre, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Razavi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Centre, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mobina Gheibi
- Student Research Committee, School of Allied Medical Sciences, Mazandaran University of Medical Science, Sari, Iran
| | | | - Peter D. Sly
- Child Health Research Centre, The University of Queensland, South Brisbane, QLD, Australia
| | - Kirsten M. Spann
- Centre for Immunology and Infection Control, Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Keng Yih Chew
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
| | - Yanshan Zhu
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia
| | - Yao Xia
- School of Science, Edith Cowan University; School of Biomedical Science, University of Western Australia, Perth, WA, Australia
| | - Timothy J. Wells
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Alexandra Cristina Senegaglia
- Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil,Core for Cell Technology, School of Medicine, PontifìciaUniversidade Católica do Paraná, Curitiba, Brazil
| | - Carmen Lúcia Kuniyoshi
- Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil,Core for Cell Technology, School of Medicine, PontifìciaUniversidade Católica do Paraná, Curitiba, Brazil
| | | | | | | | - Sepideh Motamen
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Reza Valadan
- Molecular and Cell Biology Research Centre, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran,Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omolbanin Amjadi
- Gastrointestinal Cancer Research Centre, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Rajan Gogna
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark,Novo Nordisk Foundation centre for Stem Cell Biology, DanStem, Faculty of Health and Medical Sciences, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Esha Madan
- Campania Centre for the Unknown, Lisbon, Portugal
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Centre, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Liliana Lamperti
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile
| | - Felipe Zuñiga
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile
| | - Estefania Nova-Lamperti
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile
| | - Gonzalo Labarca
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile,Faculty of Medicine, Universidad de Concepcion, Concepcion, Chile
| | - Ben Knippenberg
- Infectious Diseases Department, Royal Darwin Hospital, Darwin, NT, Australia
| | - Velma Herwanto
- Faculty of Medicine, Universitas Tarumanagara, Jakarta, Indonesia
| | - Ya Wang
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia,Centre for Immunology and Allergy Research, the Westmead Institute for Medical Research, Westmead, NSW, Australia,Department of Medicine, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, NSW, Australia
| | - Amy Phu
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia,Westmead Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Tracy Chew
- Sydney Informatics Hub, Core Research Facilities, University of Sydney, Sydney, NSW, Australia
| | - Timothy Kwan
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
| | - Karan Kim
- Centre for Immunology and Allergy Research, the Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Sally Teoh
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
| | - Tiana M. Pelaia
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
| | - Win Sen Kuan
- Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yvette Jee
- Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore
| | - Jon Iredell
- Faculty of Medicine and Health, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia,Centre for Infectious Diseases and Microbiology, Westmead Institute for Medical Research, Sydney, NSW, Australia,Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Ken O’Byrne
- Queensland University of Technology, Centre for Genomics and PersonalisedHealth, School of Biomedical Sciences, Brisbane, QLD, Australia
| | - John F. Fraser
- Critical Care Research Group, The University of Queensland, Brisbane, QLD, Australia
| | - Melissa J. Davis
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Melbourne, VIC, Australia,Department of Medical Biology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia,Department of Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Gabrielle T. Belz
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Majid E. Warkiani
- Australia Centre for Health Technologies (CHT) & Institute for Biomedical Materials & Devices (IBMD), School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, Australia
| | - Carlos Salomon Gallo
- Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile,Exosome Biology Laboratory, Centre for Clinical Diagnostics, University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital, The University of Queensland, Brisbane, QLD, Australia
| | | | - Quan Nguyen
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Anthony Mclean
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia
| | - Arutha Kulasinghe
- Frazer Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia,*Correspondence: Arutha Kulasinghe, ; Kirsty R. Short, ; Maryam Shojaei,
| | - Kirsty R. Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, Australia,*Correspondence: Arutha Kulasinghe, ; Kirsty R. Short, ; Maryam Shojaei,
| | - Benjamin Tang
- Department of Intensive Care Medicine, Nepean Hospital, Penrith, NSW, Australia,Centre for Immunology and Allergy Research, the Westmead Institute for Medical Research, Westmead, NSW, Australia
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Jafarpour H, Ghasemian R, Raei M, Razavi A. Senility and COVID-19 as two possible risk factors for loss of consciousness: A rare case report. Ann Med Surg (Lond) 2022; 80:104240. [PMID: 35946037 PMCID: PMC9354443 DOI: 10.1016/j.amsu.2022.104240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/13/2022] [Accepted: 07/19/2022] [Indexed: 11/27/2022] Open
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Rezai MS, Ahangarkani F, Hill A, Ellis L, Mirchandani M, Davoudi A, Eslami G, Roozbeh F, Babamahmoodi F, Rouhani N, Alikhani A, Najafi N, Ghasemian R, Mehravaran H, Hajialibeig A, Navaeifar MR, Shahbaznejad L, Rahimzadeh G, Saeedi M, Alizadeh-Navai R, Moosazadeh M, Saeedi S, Razavi-Amoli SK, Rezai S, Rostami-Maskopaee F, Hosseinzadeh F, Movahedi FS, Markowitz JS, Valadan R. Non-effectiveness of Ivermectin on Inpatients and Outpatients With COVID-19; Results of Two Randomized, Double-Blinded, Placebo-Controlled Clinical Trials. Front Med (Lausanne) 2022; 9:919708. [PMID: 35783616 PMCID: PMC9244711 DOI: 10.3389/fmed.2022.919708] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023] Open
Abstract
Background Ivermectin which was widely considered as a potential treatment for COVID-19, showed uncertain clinical benefit in many clinical trials. Performing large-scale clinical trials to evaluate the effectiveness of this drug in the midst of the pandemic, while difficult, has been urgently needed. Methods We performed two large multicenter randomized, double-blind, placebo-controlled clinical trials evaluating the effectiveness of ivermectin in treating inpatients and outpatients with COVID-19 infection. The intervention group received ivermectin, 0.4mg/kg of body weight per day for 3 days. In the control group, placebo tablets were used for 3 days. Results Data for 609 inpatients and 549 outpatients were analyzed. In hospitalized patients, complete recovery was significantly higher in the ivermectin group (37%) compared to placebo group (28%; RR, 1.32 [95% CI, 1.04–1.66]; p-value = 0.02). On the other hand, the length of hospital stay was significantly longer in the ivermectin group with a mean of 7.98 ± 4.4 days compared to the placebo receiving group with a mean of 7.16 ± 3.2 days (RR, 0.80 [95% CI, 0.15–1.45]; p-value = 0.02). In outpatients, the mean duration of fever was significantly shorter (2.02 ± 0.11 days) in the ivermectin group versus (2.41 ± 0.13 days) placebo group with p value = 0.020. On the day seventh of treatment, fever (p-value = 0.040), cough (p-value = 0.019), and weakness (p-value = 0.002) were significantly higher in the placebo group compared to the ivermectin group. Among all outpatients, 7% in ivermectin group and 5% in placebo group needed to be hospitalized (RR, 1.36 [95% CI, 0.65–2.84]; p-value = 0.41). Also, the result of RT-PCR on day five after treatment was negative for 26% of patients in the ivermectin group versus 32% in the placebo group (RR, 0.81 [95% CI, 0.60–1.09]; p-value = 0.16). Conclusion Our data showed, ivermectin, compared with placebo, did not have a significant potential effect on clinical improvement, reduced admission in ICU, need for invasive ventilation, and death in hospitalized patients; likewise, no evidence was found to support the prescription of ivermectin on recovery, reduced hospitalization and increased negative RT-PCR assay for SARS-CoV-2 5 days after treatment in outpatients. Our findings do not support the use of ivermectin to treat mild to severe forms of COVID-19. Clinical Trial Registration www.irct.ir IRCT20111224008507N5 and IRCT20111224008507N4.
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Affiliation(s)
- Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- *Correspondence: Mohammad Sadegh Rezai,
| | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Andrew Hill
- Department of Pharmacology and Therapeutics, Liverpool University, Liverpool, United Kingdom
| | - Leah Ellis
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Manya Mirchandani
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Alireza Davoudi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Gohar Eslami
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Roozbeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nima Rouhani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Alikhani
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Narges Najafi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mehravaran
- Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azin Hajialibeig
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Navaeifar
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Shahbaznejad
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Golnar Rahimzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Saeedi
- Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navai
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahab Saeedi
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Shaghayegh Rezai
- Department of Microbiology and Virology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Rostami-Maskopaee
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Hosseinzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - John S. Markowitz
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, United States
| | - Reza Valadan
- Department of Immunology and Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Kamali M, Azizi M, Moosazadeh M, Mehravaran H, Ghasemian R, Reskati MH, Elyasi F. Occupational burnout in Iranian health care workers during the COVID-19 pandemic. BMC Psychiatry 2022; 22:365. [PMID: 35643438 PMCID: PMC9143709 DOI: 10.1186/s12888-022-04014-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM Health care workers (HCWs), mostly frontliners, are encountering numerous physical and psychosocial stressors, and even managing some conflicts over the course of the novel coronavirus disease 2019 (COVID-19). In this respect, the present study was to investigate the prevalence rate of occupational burnout (OB) in such workers during this pandemic. MATERIALS AND METHODS This cross-sectional study was conducted between April 6 and May 30, 2020, via an online survey in 31 provinces of Iran, on HCWs selected based on convenience sampling method. For data collection, a socio-demographic information form and the Maslach Burnout Inventory (MBI) was utilized. Descriptive statistics, Chi-square test, and multivariate regression analysis were also applied to test the research hypotheses. RESULTS In total, 7626 HCWs participated in the present study. Accordingly, 73.2 and 26.8% of the workers were female and male, respectively. As well, 57.8% of the respondents were nurses and 14.4% of the cases were clinicians. Moreover, 44.8% of the participants had thus far worked in isolation wards and 40.3% of these individuals reported working for 4-8 hours with COVID-19 patients. The prevalence rate of OB was 18.3%. Besides, 34.2, 48.7, and 56.1% of the respondents had severe levels of emotional exhaustion (EE), higher depersonalization (DP), and decreased sense of personal accomplishment (PA), respectively. Besides, the HCWs at the age range of 20 to 30, having female gender, no children, and a bachelor's degree, and working in isolation wards showed the higher levels of OB with reference to the Chi-square test results (p < 0.001). Accordingly, the statistical test outcomes demonstrated that a history of physical illnesses (p = 0.001) and psychiatric disorders (p = 0.044) could be the best predictor of OB throughout the first peak of the COVID-19 pandemic. CONCLUSION Regarding the high prevalence rate of OB among the HCWs and the remaining COVID-19 journey in Iran, health care managers are recommended to orient the required management and coping strategies toward improving mental health in these individuals.
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Affiliation(s)
- Mahsa Kamali
- grid.411623.30000 0001 2227 0923Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marzieh Azizi
- grid.411705.60000 0001 0166 0922Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran university of Medical Sciences, Tehran, Iran ,grid.411623.30000 0001 2227 0923Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- grid.411623.30000 0001 2227 0923Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mehravaran
- grid.411623.30000 0001 2227 0923Department of Internal Medicine, Pulmonary and Critical Care Division, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- grid.411623.30000 0001 2227 0923Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Hasannezhad Reskati
- grid.411623.30000 0001 2227 0923Educational Psychology, Research Ethics Committee, Imam khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran. .,Department of Psychiatry, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. .,Psychosomatic Ward, Imam Khomeini General Hospital, Razi Ave, Sari, Mazandaran, Iran.
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Heydari K, Yousefi M, Alizadeh-Navaei R, Lotfi P, Sheydaee F, Raei M, Vahdatinia A, Hessami A, Rafati S, Moosazadeh M, Ghasemian R, Salehi F, Massoudi H, Ghaffari-Saravi F, Rismantab S. Helicobacter pylori Infection and Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Turk J Gastroenterol 2022; 33:171-181. [PMID: 35410853 PMCID: PMC9128487 DOI: 10.5152/tjg.2022.21467] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Since numerous studies have stated that there may be a relationship between Helicobacter pylori infection and nonalcoholic fatty liver disease, and because of the high prevalence of both conditions worldwide, this study investigated the risk of non-alcoholic fatty liver disease in patients infected with H. pylori. Following a systematic review of PubMed, Scopus, Web of Science and Embase, and a search in Google Scholar using MeSH terms such as H. pylori and non-alcoholic fatty liver disease, the relevant papers up to November 2020 were reviewed. All cohort, case-control, and cross-sectional studies that examined the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori entered this study. A meta-analysis was conducted in STATA 11. This systematic review examined 22 papers with 117 117 participants (33 711 patients infected with H. pylori and 83 406 participants as control) and 20 studies were subjected to meta-analysis The results indicated a 22% to 27% increase in the risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori (crude odds ratio: 1.27, 95% CI: 1.17-1.33; and adjusted odds ratio: 1.22, 95% CI: 1.09-1.35). According to the subgroup analysis, the study region, sample size, and the method of diagnosing H. pylori were the factors contributing to the high heterogeneity. The meta-analysis revealed the increased risk of developing non-alcoholic fatty liver disease in patients infected with H. pylori. This indicates that H. pylori is a serious risk factor in patients susceptible to NAFLD.
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Affiliation(s)
- Keyvan Heydari
- Student Research Committee, Mazandaran University of Medical Sciences Faculty of Medicine, Sari, Iran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Yousefi
- Department of Medicine, Semnan University of Medical Sciences Faculty of Medicine, Semnan, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Corresponding author: Sahar Rismantab or Reza Alizadeh-Navaei, e-mail: ;
| | - Parisa Lotfi
- Student Research Committee, Mazandaran University of Medical Sciences Faculty of Medicine, Sari, Iran
| | - Fateme Sheydaee
- Department of Medicine, Semnan University of Medical Sciences Faculty of Medicine, Semnan, Iran
| | - Maedeh Raei
- Sari Branch, Islamic Azad University Faculty of Medicine, Sari, Iran
| | - Alireza Vahdatinia
- Student Research Committee, Mazandaran University of Medical Sciences Faculty of Medicine, Sari, Iran
| | - Amirhossein Hessami
- Student Research Committee, Mazandaran University of Medical Sciences Faculty of Medicine, Sari, Iran
| | - Sajjad Rafati
- Student Research Committee, Mazandaran University of Medical Sciences Faculty of Medicine, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Salehi
- Department of Pathology, Sari branch, Islamic Azad University Faculty of Medicine, Sari, Iran
| | - Haleh Massoudi
- Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
| | - Fatemeh Ghaffari-Saravi
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sahar Rismantab
- Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
- Corresponding author: Sahar Rismantab or Reza Alizadeh-Navaei, e-mail: ;
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Ghasemian R, Bandegani A, Kermani F, Faeli L, Roohi B, Yousefi-Abdolmaleki E, T Hedayati M, Roilides E, Shokohi T. Fatal pulmonary Scedosporium aurantiacum infection in a patient after near-drowning: A case report. Curr Med Mycol 2022; 7:38-42. [PMID: 35747733 PMCID: PMC9175145 DOI: 10.18502/cmm.7.4.8410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/28/2021] [Accepted: 11/30/2021] [Indexed: 12/04/2022] Open
Abstract
Background and Purpose: Scedosporium spp. is a saprophytic fungus that may cause invasive pulmonary infection due to the aspiration of contaminated water in both immunosuppressed and immunocompetent hosts. Case report: Herein, we report a fatal case of pulmonary infection caused by Scedosporium species associated with a car crash and near-drowning in a sewage canal.
Scedosporium aurantiacum isolated from bronchoalveolar lavage was identified by PCR-sequencing of β-tubulin genes. The minimum inhibitory concentration values
for amphotericin B, itraconazole, posaconazole, isavuconazole were >16 µg/ml, and >8 µg/ml for anidulafungin, micafungin, and caspofungin.
Voriconazole was found to be the most active agent with a MIC of 1 µg/ml. Conclusion: This report, as the first case of pulmonary scedosporiosis after near-drowning in Iran, highlights the importance of high suspicion in near-drowning victims,
prompt identification of Scedosporium spp., and early initiation of appropriate antifungal therapy.
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Affiliation(s)
- Roya Ghasemian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Azadeh Bandegani
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Firoozeh Kermani
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran
| | - Leila Faeli
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Behrad Roohi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Yousefi-Abdolmaleki
- Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad T Hedayati
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Emmanuel Roilides
- Infectious Diseases Section, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
| | - Tahereh Shokohi
- Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Alikhani A, Ghazaiean M, Ghasemian R, Khademloo M. Atazanavir versus lopinavir on Covid-19 infection: A retrospective protease inhibitors comparative study 2020. Caspian J Intern Med 2022; 13:173-179. [PMID: 35872684 PMCID: PMC9272962 DOI: 10.22088/cjim.13.0.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 09/21/2021] [Accepted: 10/18/2021] [Indexed: 11/07/2022]
Abstract
Background Evaluation of protease inhibitors (PIs) is important in terms of prescribing an effective regimen for reducing mortality and hospitalization in Covid-19. Therefore, follow-up of patients better determines the characteristics of existing regimens. Methods We retrospectively evaluated the demographic, co-morbidities, gastrointestinal (GI) and liver complications of patients at two teaching hospitals from the first of March to the end of July 2020. All patients received one of two recommended regimens including hydroxychloroquine (HCQ) (400 mg BD on the first day and then 200 mg BD) plus atazanavir/ritonavir (ATV) (300/100 mg daily) or HCQ with the same dose plus lopinavir/ritonavir (Kaletra) (400/100 mg BD) for 5-7 days. Results We chose 170 cases that received 2 different regimens. In group one, 85(57.6% males) patients received Kaletra and HCQ and group two, 85 (55.3% males) patients received ATV and HCQ. The study of hospitalization in both groups showed no difference in more or less than 5 days hospitalization. (P=0.757) Comparison of mortality rates has not shown a significant difference including 19 (22.4%) deaths in group 1 and 15(17.6%) deaths in group 2 (P=0.443). Nausea followed by diarrhea was the most common side effects in group 1. But no side effects were reported in group 2 (P=0.000). Abnormal liver function tests (LFTs) were seen in both groups. Conclusion Comparison of hospitalization and mortality were not statistically significant. It seems that a respect to similar effect on mortality and hospitalization. ATV regimen is superior to Kaletra especially for better GI tolerance and less daily pills.
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Affiliation(s)
- Ahmad Alikhani
- Department of Infectious Diseases, Antimicrobial Resistance Research Center and Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mobin Ghazaiean
- School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center and Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran,Correspondence: Roya Ghasemian, Department of Infectious Diseases, Antimicrobial Resistance Research Center and Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran. E-mail: , Tel: 0098 1133378840, Fax: 0098 1133378840
| | - Mohammad Khademloo
- Department of Community Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Ghasemian R, Shamshirian A, Heydari K, Malekan M, Alizadeh‐Navaei R, Ebrahimzadeh MA, Ebrahimi Warkiani M, Jafarpour H, Razavi Bazaz S, Rezaei Shahmirzadi A, Khodabandeh M, Seyfari B, Motamedzadeh A, Dadgostar E, Aalinezhad M, Sedaghat M, Razzaghi N, Zarandi B, Asadi A, Yaghoubi Naei V, Beheshti R, Hessami A, Azizi S, Mohseni AR, Shamshirian D. The role of vitamin D in the age of COVID-19: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14675. [PMID: 34322971 PMCID: PMC8420549 DOI: 10.1111/ijcp.14675] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/26/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Evidence recommends that vitamin D might be a crucial supportive agent for the immune system, mainly in cytokine response regulation against COVID-19. Hence, we carried out a systematic review and meta-analysis in order to maximise the use of everything that exists about the role of vitamin D in the COVID-19. METHODS A systematic search was performed in PubMed, Scopus, Embase and Web of Science up to December 18, 2020. Studies focused on the role of vitamin D in confirmed COVID-19 patients were entered into the systematic review. RESULTS Twenty-three studies containing 11 901 participants entered into the meta-analysis. The meta-analysis indicated that 41% of COVID-19 patients were suffering from vitamin D deficiency (95% CI, 29%-55%), and in 42% of patients, levels of vitamin D were insufficient (95% CI, 24%-63%). The serum 25-hydroxyvitamin D concentration was 20.3 ng/mL among all COVID-19 patients (95% CI, 12.1-19.8). The odds of getting infected with SARS-CoV-2 are 3.3 times higher among individuals with vitamin D deficiency (95% CI, 2.5-4.3). The chance of developing severe COVID-19 is about five times higher in patients with vitamin D deficiency (OR: 5.1, 95% CI, 2.6-10.3). There is no significant association between vitamin D status and higher mortality rates (OR: 1.6, 95% CI, 0.5-4.4). CONCLUSION This study found that most of the COVID-19 patients were suffering from vitamin D deficiency/insufficiency. Also, there is about three times higher chance of getting infected with SARS-CoV-2 among vitamin-D-deficient individuals and about five times higher probability of developing the severe disease in vitamin-D-deficient patients. Vitamin D deficiency showed no significant association with mortality rates in this population.
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Affiliation(s)
- Roya Ghasemian
- Antimicrobial Resistance Research CenterDepartment of Infectious DiseasesMazandaran University of Medical SciencesSariIran
| | - Amir Shamshirian
- Department of Medical Laboratory SciencesStudent Research CommitteeSchool of Allied Medical ScienceMazandaran University of Medical SciencesSariIran
- Gastrointestinal Cancer Research CenterNon‐Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Keyvan Heydari
- Gastrointestinal Cancer Research CenterNon‐Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
- Student Research CommitteeSchool of MedicineMazandaran University of Medical SciencesSariIran
| | - Mohammad Malekan
- Student Research CommitteeSchool of MedicineMazandaran University of Medical SciencesSariIran
| | - Reza Alizadeh‐Navaei
- Gastrointestinal Cancer Research CenterNon‐Communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
| | - Mohammad Ali Ebrahimzadeh
- Pharmaceutical Sciences Research CenterDepartment of Medicinal ChemistrySchool of PharmacyMazandaran University of Medical ScienceSariIran
| | - Majid Ebrahimi Warkiani
- School of Biomedical EngineeringUniversity of Technology SydneySydney, UltimoNSWAustralia
- Institute of Molecular MedicineSechenov First Moscow State UniversityMoscowRussia
| | - Hamed Jafarpour
- Student Research CommitteeSchool of MedicineMazandaran University of Medical SciencesSariIran
| | - Sajad Razavi Bazaz
- School of Biomedical EngineeringUniversity of Technology SydneySydney, UltimoNSWAustralia
| | | | - Mehrdad Khodabandeh
- Neuromusculoskeletal Research CenterDepartment of Physical Medicine and RehabilitationIran University of Medical SciencesTehranIran
| | - Benyamin Seyfari
- Department of SurgeryFaculty of MedicineKashan University of Medical SciencesKashanIran
| | - Alireza Motamedzadeh
- Department of Internal MedicineFaculty of MedicineKashan University of Medical SciencesKashanIran
| | - Ehsan Dadgostar
- Department of PsychiatrySchool of MedicineIsfahan University of Medical SciencesIsfahanIran
| | - Marzieh Aalinezhad
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Meghdad Sedaghat
- Department of Internal MedicineImam Hossein HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Nazanin Razzaghi
- Student Research CommitteeGolestan University of Medical SciencesGorganIran
| | - Bahman Zarandi
- Student Research CommitteeIran University of Medical SciencesTehranIran
| | - Anahita Asadi
- Pharmaceutical Sciences Research CenterDepartment of Medicinal ChemistrySchool of PharmacyMazandaran University of Medical ScienceSariIran
| | | | - Reza Beheshti
- Pharmaceutical Sciences Research CenterDepartment of Medicinal ChemistrySchool of PharmacyMazandaran University of Medical ScienceSariIran
| | - Amirhossein Hessami
- Department of Medical Laboratory SciencesStudent Research CommitteeSchool of Allied Medical ScienceMazandaran University of Medical SciencesSariIran
| | - Soheil Azizi
- Department of Medical Laboratory SciencesSchool of Allied Medical ScienceMazandaran University of Medical SciencesSariIran
| | - Ali Reza Mohseni
- Department of Medical Laboratory SciencesSchool of Allied Medical ScienceMazandaran University of Medical SciencesSariIran
- Thalassemia Research CenterHemoglobinopathy InstituteMazandaran University of Medical SciencesSariIran
| | - Danial Shamshirian
- Chronic Respiratory Diseases Research CenterNational Research Institute of Tuberculosis and Lung Diseases (NRITLD)Shahid Beheshti University of Medical SciencesTehranIran
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14
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Mobini M, Ghasemian R, Vahedi Larijani L, Mataji M, Maleki I. Immunologic markers, vasculitis-associated autoantibodies, and complement levels in patients with COVID-19. J Res Med Sci 2021; 26:103. [PMID: 34899941 PMCID: PMC8607177 DOI: 10.4103/jrms.jrms_923_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/15/2020] [Accepted: 02/24/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The cause of coronavirus disease 2019 (COVID-19) is a virus which can lead to severe acute respiratory syndrome-CoV-2 (SARS-COV-2). There are evidences of involvement of immune system in pathogenesis of this disease. We investigated the presence of various vasculitis-associated autoantibodies and complement levels in patients with COVID-19. MATERIALS AND METHODS Patients with severe or critical type of COVID-19 were evaluated for symptoms, signs, and laboratory tests of vasculitis syndromes including rheumatoid factor (RF), antinuclear antibody (ANA), anti-double-stranded DNA, c and p anti-neutrophilic cytoplasmic antibody (c ANCA and P ANCA), and complement levels. RESULTS The study was performed in forty patients with severe or critical illness. The mean age of the participants was 48.5 ± 9.8 years. All patients had pulmonary involvement in lung computed tomography scans. Vasculitis laboratory test results included RF in two patients, ANA in three patients, and ANCA in one patient. Seventeen (42.5%) patients had hypocomplementemia in one or more complement tests. Four patients expired, of whom three had a decrease in complement level. CONCLUSION Decrease in complement levels may predict a critical state of COVID-19 disease. Therefore, measuring its levels may be of great benefit in making earlier decisions to initiate disease-suppressing treatments including corticosteroids.
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Affiliation(s)
- Maryam Mobini
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Laleh Vahedi Larijani
- Immunogenetic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maede Mataji
- Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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15
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Kamali M, Moosazadeh M, Azizi M, Ghasemian R, Hasannezad Reskati M, Elyasi F. Anxiety due to COVID-19 among healthcare providers during pandemic: A web-based cross-sectional survey in Iran. Neuropsychopharmacol Rep 2021; 41:496-510. [PMID: 34647435 PMCID: PMC8646633 DOI: 10.1002/npr2.12213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/13/2021] [Accepted: 09/28/2021] [Indexed: 12/23/2022] Open
Abstract
AIM The main purpose of this study was to assess the levels of anxiety, depression, and stress among healthcare providers in Iran. METHODS This descriptive cross-sectional survey was performed on healthcare providers selected through the convenience sampling method from April 6 to May 19, 2020, during the COVID-19 pandemic. To this end, a self-report web-based questionnaire made up of a sociodemographic characteristics information form, Depression, Anxiety, and Stress Scale (DASS), and Corona Disease Anxiety Scale (CDAS) was distributed. Descriptive statistics, chi-square test (χ2 ), and univariate and multivariate logistic regression models were accordingly practiced to analyze the data using the Statistical Package for Social Sciences (SPSS) software. RESULTS Of 1343 healthcare providers, 45.8% and 73.0% had moderate physical and psychological anxiety symptoms, respectively. The logistic regression model similarly demonstrated that anxiety caused by COVID-19 was significantly correlated with the age ranges of 41-50 (P = .007) and 51-60 (P = .014) years as well as male participants (P < .001). In addition, the prevalence rates of depression and stress were, respectively, reported by 35.1% and 27.8%. There was correspondingly a significant relationship between depression and age as well as stress and gender. CONCLUSIONS It seems that healthcare managers need to focus more attention on psychological aspects in healthcare providers during this pandemic and plan to teach them about coping strategies.
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Affiliation(s)
- Mahsa Kamali
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marzieh Azizi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Hasannezad Reskati
- Research Ethics Committee, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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16
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Monajati M, Ala S, Aliyali M, Ghasemian R, Heidari F, Ahanjan M, Moradi S, Sharifpour A, Mojtahedzadeh M, Salehifar E. Clinical Effectiveness of a High Dose Versus the Standard Dose of Meropenem in Ventilator-associated Pneumonia Caused by Multidrugresistant Bacteria: A Randomized, Single-blind Clinical Trial. Infect Disord Drug Targets 2021; 21:274-283. [PMID: 32106807 DOI: 10.2174/1871526520666200227102013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/01/2020] [Accepted: 02/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Meropenem standard doses are based on the minimum inhibitory concentration of sensitive pathogens and the pharmacokinetic parameter of not critically ill patients. We compared the efficacy of high versus standard dose of meropenem in ventilator-associated pneumonia (VAP). ; Methods: 24 out of 34 eligible patients were randomized to receive meropenem 3 g q8h (high dose group, 11 patients) or 2 g q8h (standard-dose group, 13 patients) as a 3h infusion. The primary outcome was considered as clinical success that was defined as stable hemodynamic, improved sequential organ failure assessment (SOFA) score, stable or improved PaO2/FiO2 after 7 days. Sputum culture was taken before the intervention. ; Results: Clinical success rate was not significantly different between the high and standard-dose group (54.5% vs. 38.5%, P= 0.431). There was a significant difference in the reduction of clinical pulmonary infection score (CPIS) compared to a high dose to the standard group (P=0.038). SOFA score declined significantly in the high dose group throughout the study (P=0.006). A shorter duration of VAP treatment was recorded in the high dose group (P=0.061). We did not observe any significant adverse event related to meropenem. Acinetobacter spp. (34.8%), Klebsiella spp. (32.6%) and Pseudomonas aeruginosa (19.5%) isolated more frequently from sputum cultures. ; Conclusion: Treatment with the high dose of meropenem seems to be safe. However, it did not provide a significantly higher clinical success rate in comparison with the standard dose, but could be considered as an appropriate empirical treatment in patients with severe infection due to reduction in SOFA and CPIS. ; The trial protocol was registered with IRCT.ir (registration number IRCT2010010700 3014N19 in April 2018).
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Affiliation(s)
- Mahila Monajati
- Department of Clinical Pharmacy, Faculty of Pharmacy, Pharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahram Ala
- Department of Clinical Pharmacy, Faculty of Pharmacy, Pharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Aliyali
- Division of Pulmonary and Critical Care, Department of Internal Medicine, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Department of Infectious Disease, Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Heidari
- Department of Anesthesiology and Critical Care, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ahanjan
- Department of Microbiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Moradi
- Education Development Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Toxoplasmosis Research Center, Iranian National Registry Center for Lophmaniasis (INRCL), Mazandaran University of Medical Sciences, PO Box 48471-91971, Sari, Iran
| | - Mojtaba Mojtahedzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Salehifar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Pharmaceutical Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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17
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Azizi M, Kamali M, Moosazadeh M, Aarabi M, Ghasemian R, Hasannezhad Reskati M, Elyasi F. Assessing mental health status among Iranian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study. Brain Behav 2021; 11:e2304. [PMID: 34333852 PMCID: PMC8413818 DOI: 10.1002/brb3.2304] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The present study was conducted to assess 3(HCWs) during the COVID-19 pandemic. METHODS A total number of 7626 HCWs were included in this web-based cross-sectional study, via the convenience sampling technique. To collect the required data, the sociodemographic characteristics information form, the Depression Anxiety Stress Scale-21 (DASS-21), and the Corona Disease Anxiety Scale (CDAS) were also employed. In addition, data analysis was performed using the SPSS Statistics software (ver. 24), as well as descriptive statistics, Chi-square test (χ2 ), and univariate/multivariate logistic regression models. RESULTS The CDAS results revealed that 47.9% and 70.5% of the HCWs had experienced moderate levels of physical and psychological anxiety, respectively. Based on the DASS results, 44.8%, 43%, and 34.8% of the HCWs had been subjected to depression, anxiety, and stress symptoms during the COVID-19 pandemic, respectively. The logistic regression models correspondingly showed that depression among the HCWs was significantly correlated with risk factors, such as the age groups of 20-30 years (p = .001), 31-40 years (p = .006), female HCWs (p> .001), history of physical illnesses (p = .004), and history of psychiatric disorders (p> .001). Moreover, factors including the age groups of 20-30 years (p < .001), 31-40 years (p < .001), 41-50 years (p < .001), female HCWs (p> .001), history of physical illnesses (p < .001), and history of psychiatric disorders (p>.001) were assumed as significant predictors of anxiety in these individuals. Besides, factors such as the age groups of 20-30 years (p = .002), 31-40 years (p = .004), female HCWs (p>.001), occupation (p = .016), history of physical illnesses (p < .001), and history of psychiatric disorders (p> .001) could significantly predict the prevalence rate of stress in the HCWs in times of this crisis. CONCLUSION Given the importance of mental health status among HCWs during the COVID-19 pandemic, health administrators and policymakers of the Ministry of Health and Medical Education in Iran are suggested to provide psychological screening and supportive care programs for HCWs with the aim of enhancing their mental health and successful coping with critical circumstances.
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Affiliation(s)
- Marzieh Azizi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Kamali
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohsen Aarabi
- Department of Family Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Hasannezhad Reskati
- Research Ethics Committee, Imam khomeini Hospital, Mazandaran, University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Imam Khomeini General Hospital, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
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18
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Bazgir ZN, Ahanjan M, Goli HR, Gholami M, Ghasemian R, Hashemi-Soteh MB. Frequency of bla IMP and bla SPM Metallo-β-Lactamase Genes among Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolates in Sari, North of Iran. Recent Adv Antiinfect Drug Discov 2021; 16:148-156. [PMID: 34961433 DOI: 10.2174/2772434416666210607141520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Metallo-β-lactamases (MBLs) play a major role in the resistance of Pseudomonas aeruginosa to carbapenems. We investigated the antibiotic susceptibility patterns and frequency of MBLs genes (blaIMP and blaSPM) in carbapenem-resistant P. aeruginosa clinical isolates in Sari, Iran. MATERIALS AND METHODS The isolates were identified using standard microbiological tests, and their antibiotic susceptibility pattern was determined by the disk agar diffusion method according CLSI criteria. Phenotypic identification of MBL-producing strains assessed by the combined disk test (CDT). Then, polymerase chain reaction (PCR) was used to detect the presence of blaIMP and blaSPM genes. RESULTS The highest and lowest levels of antibiotic resistance were observed against gentamicin (40%) and piperacillin-tazobactam (13%), respectively. Besides, 40 isolates (40%) had the multi-drug resistant (MDR) phenotype, while 5 (12.5%) MDR isolates were resistant to all antibiotics tested. The results of the CDT showed that among 43 carbapenem non-susceptible clinical isolates of P. aeruginosa, 33 (76.74%) isolates were MBL-producing strains. Also, the frequency of the blaIMP gene among 43 carbapenem non susceptible isolates was determined to be 6.97%, while none of these isolates carried the blaSPM gene. CONCLUSION Due to the high prevalence of carbapenem-resistant and MDR P. aeruginosa in this study, routine antibiotic susceptibility testing and phenotypic identification of carbapenemase production by this bacterium are necessary for the proper selection of antibiotics.
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Affiliation(s)
- Zahra Norouzi Bazgir
- Molecular and Cell Biology Research Centre, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Ahanjan
- Pediatric Infectious Disease Research Center, Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamid Reza Goli
- Molecular and Cell Biology Research Centre, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehrdad Gholami
- Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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19
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Zaboli E, Ghasemian R, Abounoori M, Zahedi M, Hashemi ,SA. Deep Vein Thrombosis Associated With COVID-19. PBR 2021. [DOI: 10.18502/pbr.v6i(s2).5661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The novel coronavirus disease 2019 (COVD-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The immunothrombosis could occur during infectionwith viruses. Deep vein thrombosis (DVT) is a devastating condition that usually involves the lower extremities. The typical course of DVT is associated with an episode of enormous limbswelling and pain. In this case report, we aimed to present one of the COVID-19 possible complications: DVT in a 38 years old man infected with SARS-CoV-2. A 38 years old manpresented with leg pain. He had a dry cough and fatigue suspicious symptoms of COVID-19. For further evaluations, the lung Computed Tomography scan (CT-scan), labratoricalassessments, and doppler sonography of the common femoral vein (CFV) of both legs were done. Also, for investigating the other underlying causes of DVT, abdominopelvic CT-scan andlumbosacral Magnetic Resonance Imaging (MRI) were done. The CT-scan showed GroundGlass Opacity (GGO) view. Labratorical assessment proposed a thrombotic condition. Thedoppler sonography of the CFV of both legs revealed a massive thrombosis in the left CFV suggesting an acute DVT. Abdominopelvic CT-scan and lumbosacral MRI were negativefor other underlying causes of DVT. COVID-19 is associated with the classical syndrome named disseminated intravascular coagulation and the subsequent consumption coagulopathypresented as DVT.
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20
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Khasayesi M, Kashi Z, Ilali NM, Ghasemian R, Eslamijoubari M, Hosseini-Khah Z. Association of ABO and Rhesus Blood Groups with the Severity of SARS-CoV-2 Infection: A Cross-sectional Analytical Study. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/51103.15716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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21
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Majidi H, Bani-Mostafavi ES, Mardanshahi Z, Godazandeh F, Ghasemian R, Heydari K, Alizadeh-Navaei R. High-resolution computed tomography finding in 552 patients with symptomatic COVID-19: first report from north of Iran. Emerg Radiol 2020; 27:633-639. [PMID: 32661945 PMCID: PMC7355135 DOI: 10.1007/s10140-020-01819-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/06/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Due to the emergence of the new coronavirus 2019 and the lack of sufficient information about infected patients, this study was conducted to investigate the chest high-resolution computed tomography (HRCT) findings of patients infected with the new coronavirus 2019. METHODS This cross-sectional study was performed on COVID-19 patients referred to Medical Imaging Centers of Sari, Mazandaran, Iran, on March 2020 for computed tomography (CT) scan. Symptomatic patients were referred to the Medical Imaging Center for diagnosis confirmation through CT scan. In addition to age and sex, HRCT findings were collected from the picture archiving and communication system (PACS) for further evaluations. RESULTS Out of 552 patients with mean age of 51.2 ± 14.8 years, the male/female ratio was 1.38 to 1. The most common expressive findings in patients were ground-glass opacity (GGO) (87.3%), peripheral distribution (82.4%), and posterior distribution (81.5%). The most conflicting findings in patients were pleural effusion (7.6%), peribronchovascular distribution (7.6%), and lymphadenopathy (5.1%). The peripheral distribution (p = 0.034), round opacities (p = 0.02), single lobe (p = 0.003), and pleural effusion (p = 0.037) were significant in people under and over 50 years of age. CONCLUSION In summary, the present study indicated that in addition to GGO, peripheral distribution findings could be a vital diagnostic choice in COVID-19 patients.
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Affiliation(s)
- Hadi Majidi
- Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Zahra Mardanshahi
- Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farnaz Godazandeh
- Department of Radiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keyvan Heydari
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
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22
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Malekzadeh R, Abedini A, Mohsenpour B, Sharifipour E, Ghasemian R, Javad-Mousavi SA, Khodashahi R, Darban M, Kalantari S, Abdollahi N, Salehi MR, Rezaei Hosseinabadi A, Khorvash F, Valizadeh M, Dastan F, Yousefian S, Hosseini H, Anjidani N, Tabarsi P. Subcutaneous tocilizumab in adults with severe and critical COVID-19: A prospective open-label uncontrolled multicenter trial. Int Immunopharmacol 2020; 89:107102. [PMID: 33075713 PMCID: PMC7553010 DOI: 10.1016/j.intimp.2020.107102] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 12/15/2022]
Abstract
Potential therapeutic approaches in coronavirus disease 2019 (COVID-19) comprise antiviral and immunomodulatory agents; however, no immunomodulator drug has been approved. This multicenter, prospective, open-label, uncontrolled study aimed to assess the use of subcutaneous tocilizumab in adult patients with severe and critical COVID-19. Tocilizumab was added to the standard care of therapy at a dose of 324 mg (<100 kg bodyweight) or 486 mg (≥100 kg bodyweight). The study endpoints were all-cause mortality rate, changes in oxygen-support level, oxygen saturation, body temperature, respiratory rate, and laboratory variables during the study, and drug safety. Of 126 patients enrolled, 86 had severe and 40 had critical disease. Most patients were male (63.49%) and aged below 65 (78.57%). By day 14 of the study, 4.65% (4/86) of severe patients and 50.00% (20/40) of critical patients died. By the end, 6.98% (6/86) of severe patients and 60.00% (24/40) of critical patients died.Outcomes concerning three additional endpoints (oral temperature, oxygen saturation, and respiratory rate)were significantly improved as early as three days after tocilizumab administration in both groups of subjects, more considerably in severe patients. Significant improvement in the required level of oxygenation was reported in severe patients seven days after tocilizumab administration. No tocilizumab-related serious adverse event occurred in this study. Subcutaneous tocilizumab might improve some clinical parameters and reduce the risk of death in COVID-19 patients, particularly if used in the early stages of respiratory failure.
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Affiliation(s)
- Reza Malekzadeh
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Abedini
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Mohsenpour
- Department of Infectious Disease, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ehsan Sharifipour
- Neuroscience Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Ali Javad-Mousavi
- Department of Pulmonology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Rozita Khodashahi
- Department of Infectious Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboobeh Darban
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Saeed Kalantari
- Antimicrobial Resistance Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Abdollahi
- Golestan Rheumatology Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohammad Reza Salehi
- Department of Infectious Disease, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farzin Khorvash
- Department of Infectious Disease, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Melika Valizadeh
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Dastan
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Yousefian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Hosseini
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Shamshirian A, Hessami A, Heydari K, Alizadeh-Navaei R, Ebrahimzadeh MA, Yip GW, Ghasemian R, Sedaghat M, Baradaran H, Mohammadi Yazdii S, Aboufazeli E, Jafarpour H, Dadgostar E, Tirandazi B, Sadeghnezhad R, Karimifar K, Eftekhari A, Shamshirian D. The Role of Hydroxychloroquine in COVID-19 Treatment: A Systematic Review and Meta-Analysis. Ann Acad Med Singap 2020. [DOI: 10.47102/annals-acadmedsg.2020370] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19. Methods: We performed a systematic search in PubMed, Scopus, Embase, Cochrane- Library, Web of Science, Google Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064. Results: Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81–1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91–1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71–1.03) nor in HCQ plus AZM treatment group (RR: 1.28, 95% CI, 0.76–2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (P<0.00001). Conclusion: The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease. Keywords: Azithromycin, coronavirus outbreaks, pandemic, SARS-CoV-2 disease
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ehsan Dadgostar
- Halal research center of Islamic Republic of Iran, FDA, Tehran, Iran
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24
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Shamshirian A, Hessami A, Heydari K, Navaei RA, Ebrahimzadeh MA, Yip GW, Ghasemian R, Sedaghat M, Baradaran H, Yazdi SM, Aboufazeli E, Jafarpour H, Dadgostar E, Tirandazi B, Sadeghnezhad R, Karimifar K, Eftekhari A, Shamshirian D. The Role of Hydroxychloroquine in COVID-19: A Systematic Review and Meta-Analysis. Ann Acad Med Singap 2020; 49:789-800. [PMID: 33283842 DOI: pmid/33283842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19. METHODS We performed a systematic search in PubMed, Scopus, Embase, CochraneLibrary, Web of Science, Google Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064. RESULTS Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81-1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91-1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71-1.03) nor in HCQ plus AZM treatment group (RR: 1.28, 95% CI, 0.76-2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (P<0.00001). CONCLUSION The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease.
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Affiliation(s)
- Amir Shamshirian
- Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Science, Mazandaran University of Medical Sciences, Sari, Iran
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25
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Taghiloo S, Aliyali M, Abedi S, Mehravaran H, Sharifpour A, Zaboli E, Eslami-Jouybari M, Ghasemian R, Vahedi-Larijani L, Hossein-Nattaj H, Amjadi O, Rezazadeh H, Ajami A, Asgarian-Omran H. Apoptosis and immunophenotyping of peripheral blood lymphocytes in Iranian COVID-19 patients: Clinical and laboratory characteristics. J Med Virol 2020; 93:1589-1598. [PMID: 32910458 DOI: 10.1002/jmv.26505] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023]
Abstract
A novel member of human coronavirus, named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been recently recognized in China and rapidly spread worldwide. Studies showed the decreasing of peripheral blood lymphocytes in a majority of patients. In this study, we have reported the clinical features, laboratory characteristics, the frequency of peripheral blood lymphocyte subpopulations, and their apoptosis pattern in Iranian coronavirus infectious disease (COVID-19) patients. Demographic and clinical data of 61 hospitalized confirmed cases with COVID-19 at Imam Khomeini Hospital were collected and analyzed. Peripheral blood mononuclear cells were isolated from all samples and the apoptosis pattern was evaluated using Annexin V/propidium iodide method. The frequency of lymphocyte subsets, including T-CD4+ , T-CD8+ , NK, B cells, and monocytes, was measured in all patients and 31 controls by flow cytometry. Our findings demonstrated that the percentage of lymphocytes, CD4+ , and CD8+ T cells were decreased in COVID-19 patients compared with the control group. Regarding the clinical severity, the number of lymphocytes, CD4+ , CD8+ T cells, and NK cells were also decreased in severe cases when compared with mild cases. Finally, our data have also indicated the increase in apoptosis of mononuclear cells from COVID-19 patients which was more remarkable in severe clinical cases. The frequency of immune cells is a useful indicator for prediction of severity and prognosis of COVID-19 patients. These results could help to explain the immunopathogenesis of SARS-CoV-2 and introducing novel biomarkers, therapeutic strategies, and vaccine candidates.
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Affiliation(s)
- Saeid Taghiloo
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Deputy of Research and Technology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Masoud Aliyali
- Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Siavash Abedi
- Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Mehravaran
- Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ehsan Zaboli
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Eslami-Jouybari
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases and Tropical Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hadi Hossein-Nattaj
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Omolbanin Amjadi
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hadiseh Rezazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abolghasem Ajami
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Asgarian-Omran
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Internal Medicine, Pulmonary and Critical Care Division, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Immunogenetics Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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26
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Mobini M, Ahmadzade-Amiri A, Ghasemian R, Torabizadeh Z, Fakhar M. Heerfordt-Waldenström syndrome, a rare presentation of sarcoidosis in a patient with old ocular toxoplasmosis. Infect Disord Drug Targets 2020; 21:629-633. [PMID: 32901589 DOI: 10.2174/1871526520666200909094500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/19/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are similarities between ophthalmic presentation of toxoplasmosis and sarcoidosis and there are some concerns of immunosuppressive treatments for sarcoidosis may lead to T. gondii reactivation. We report a rare case with acute sarcoidosis (Heerfordt-Waldenström syndrome) and past history of ocular toxoplasmosis from the North of Iran. CASE PRESENTATION The patient was a 36-year-old woman, with left painful eye and swollen parotid, right facial paresis, maculopapular rash in left eyebrow and erythema nodosa on both legs. Anti-Toxoplasma IgG antibody was positive and IgM was not detectable. Radiographic findings on chest revealed bilateral hilar lymphadenopathy. The initial treatment was sulfamethoxazole-trimethoprim to prevent recurrence of retinal toxoplasmosis and corticosteroid and mycophenolate mofetil for sarcoidosis. The patient showed clinical and vision improvement without recurrences during three months follow-up. DISCUSSION Ophthalmological examinations and laboratory test to rule out toxoplasmosis could be considered in known cases of sarcoidosis particularly in ocular sarcoidosis status. To the best of our knowledge this is first report of co-morbidity of ocular toxoplasmosis / sarcoidosis from Iran and possibly the world.
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Affiliation(s)
- Maryam Mobini
- Department of Internal Medicine, Diabetes Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari. Iran
| | - Ahmad Ahmadzade-Amiri
- Department of Ophthalmology, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari. Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Mazandaran. Iran
| | - Zhila Torabizadeh
- Department of Pathology, Mazandaran University of Medical Sciences, Mazandaran. Iran
| | - Mahdi Fakhar
- Toxoplasmosis Research Center, Iranian National Registry Center for Toxoplasmosis (INRCT), Department of Parasitology, Mazandaran University of Medical Sciences, Sari. Iran
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27
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Jalalian R, Shokohi T, Mirzakhani R, Ghasemian R, Hedayati MT, Ardalani S, Azizi S, Kalhori S, Kermani F, Mayahi S. Fatal Prosthetic Valve Endocarditis Due to Aspergillus flavus in a Diabetic Patient. Infect Drug Resist 2020; 13:2245-2250. [PMID: 32765000 PMCID: PMC7360421 DOI: 10.2147/idr.s258637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 12/25/2022] Open
Abstract
Aspergillus endocarditis (AE) accounts for a-quarter of all fungal endocarditis, mainly in immunocompromised hosts prior to heart-valve surgery with high mortality, even with treatment. Herein, we report a rare case of AE in a diabetic 60-year-old woman with a history of redo mitral valve prosthesis suspecious of acute endocarditis. She underwent second redo surgical mitral valve replacement in combination with mechanical aortic valve replacement. Blood cultures were negative. The explanted valve and vegetation were subjected to identification. Grown colonies were identified as Aspergillus flavus, based on conventional and molecular methods. Despite the administration of liposomal amphotericin B and improvement in her general condition shortly after initiation of therapy, the patient passed away. As AE is a late consequence of redo prosthetic valve replacement, extended follow-up, early diagnosis, repeating valve-replacement surgeries, and timely selective antifungal treatments are warranted.
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Affiliation(s)
- Rozita Jalalian
- Department of Cardiology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Shokohi
- Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roghayeh Mirzakhani
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Taghi Hedayati
- Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sirus Ardalani
- Department of Cardiac Surgery, Cardiovascular Research Center of Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Soheil Azizi
- Department of Pathology, Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shamsi Kalhori
- Department of Pathology, Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Firoozeh Kermani
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Sabah Mayahi
- Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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28
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Davoodi L, Razavi A, Jafarpour H, Heshmati M, Soleymani E, Ghasemian R. Relationship Between the Prevalence of Blood Groups and Severity of Leptospirosis: A Case-Control Study. Infect Dis (Lond) 2020; 13:1178633720936273. [PMID: 32636638 PMCID: PMC7318813 DOI: 10.1177/1178633720936273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/01/2020] [Indexed: 01/18/2023] Open
Abstract
Introduction: The correlation between the prevalence and severity of leptospirosis with blood groups has not been investigated so far, but several studies have been conducted to link the infectious diseases with blood groups. The aim of this study was to investigate the prevalence of blood type in patients with leptospirosis and its association with disease severity. Methods: This is a case-control study performed on hospitalized patients with the diagnosis of leptospirosis in Mazandaran province, Iran, in 2018. The control group was selected from among the families of patients. Blood groups (ABO and Rh) and severity of the disease were assessed. Data were analyzed by SPSS 22. Results: A total of 300 people (150 in the case and 150 in the control) enrolled in the study. The mean age was 44.35 ± 15.39 years and 81.3% were men. The highest frequency of blood type in both groups was O+, A+, and B+, respectively. There was a statistically significant difference in the frequency of blood groups (P = .037). Comparison between severity of disease and blood types (ABO, Rh) showed no significant difference (P > .05). Conclusions: According to our study, O+ was the most common among patients with leptospirosis. The frequency of O in patients was significantly higher than in the control group, but there was no significant relationship between leptospirosis and Rh. The prevalence of this blood type was higher in people with a severe form of the disease. Finally, there is no statistically significant difference between the severity of the disease and ABO and Rh.
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Affiliation(s)
- Lotfollah Davoodi
- Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Alireza Razavi
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Jafarpour
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahjin Heshmati
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Eissa Soleymani
- Student Research Committee, Faculty of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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29
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Haddadi K, Ghasemian R, Shafizad M. Basal Ganglia Involvement and Altered Mental Status: A Unique Neurological Manifestation of Coronavirus Disease 2019. Cureus 2020; 12:e7869. [PMID: 32489724 PMCID: PMC7255547 DOI: 10.7759/cureus.7869] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 12/20/2022] Open
Abstract
Like other respiratory viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may enter the central nervous system (CNS) via the hematogenous or neuronal path. However, neurological complications of coronavirus disease 2019 (COVID-19) have not been reported frequently. Encephalopathy has been described as a presenting symptom or complication of COVID-19 in some reports. We report a case of a 54-year-old patient who presented with unique clinical characteristics and imaging with brain basal ganglia involvement likely due to SARS-CoV-2 infection. In our experience, the incidence of spontaneous bilateral basal ganglia hemorrhage is rare. Further study will be needed to investigate this finding of the CNS and altered mental status in patients with this new type of coronavirus infection. Based on the case presented and other cases, understanding the pathways of virus neuroinvasion is necessary to help recognize possible pathologically related consequences of infection and to evaluate new diagnostic and management approaches that will help improve SARS-CoV-2 infection treatment and control.
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Affiliation(s)
- Kaveh Haddadi
- Neurological Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, IRN
| | - Roya Ghasemian
- Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, IRN
| | - Misagh Shafizad
- Neurological Surgery, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, IRN
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30
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Eslamijouybari M, Heydari K, Maleki I, Moosazadeh M, Hedayatizadeh-Omran A, Vahedi L, Ghasemian R, Sharifpour A, Alizadeh-Navaei R. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship with Disease Prognosis. Caspian J Intern Med 2020; 11:531-535. [PMID: 33425271 PMCID: PMC7780872 DOI: 10.22088/cjim.11.0.531] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/25/2020] [Accepted: 09/07/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The present study aimed to compare the complete blood count (CBC) indices between COVID-19 patients and the control group, and assess the relationship of these indices with COVID-19 prognosis. METHODS COVID-19 patients (confirmed by PCR or CT-Scan) who visited Imam Hospital in Sari were selected in this case-control study. The control group was selected from Tabari cohort population matched with the case group in terms of gender and age. CBC, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and outcome of the disease (in the case group) were assessed in this study. RESULTS The number of participants were 527 in both case and control groups, of which, 232 (44%) were females in each arms. Platelet count, lymphocyte count, and hemoglobin concentration were also higher in the control group (P=0.000). NLR and PLR were significantly higher in COVID-19 patients compared to the control group (P=0.000). NLR had a significant relationship with the severity of the disease. NLR was two times higher in the patients who died of COVID-19 than those who recovered (P=0.000). ROC curve analysis for diagnostic values of NLR and PLR showed that the areas under the ROC curves for NLR and PLR were 0.703 (95% CI: 0.64-0.76) and 0.535 (95% CI: 0.46-06), respectively. CONCLUSION NLR can be used as a prognostic marker for COVID-19 given the significant difference of NLR between those who died and recovered from COVID-19.
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Affiliation(s)
- Mohammad Eslamijouybari
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iradj Maleki
- Gut and Liver Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Lale Vahedi
- Department of Pathology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Sharifpour
- Department of Pulmonary and Critical Care, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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31
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Shokri M, Ghasemian R, Bayani M, Maleh PA, Kamrani M, Sadeghi-Haddad-Zavareh M, Ebrahimpour S. Serum and alveolar procalcitonin had a weak diagnostic value for ventilator-associated pneumonia in patients with pulmonary infection score ≥ 6. ACTA ACUST UNITED AC 2019; 56:9-14. [PMID: 28991776 DOI: 10.1515/rjim-2017-0038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Measuring the serum and alveolar procalcitonin level as inflammatory marker in the diagnosis of ventilator-associated pneumonia (VAP) has been taken into account. In this study, serum and alveolar procalcitonin levels in patients with suspected VAP and patients with confirmed VAP were compared. METHODS This cross-sectional study was conducted using 50 intubated intensive care unit (ICU) patients, connected to ventilator, from October 2014 to April 2015. 50 patients with clinical pulmonary infection score ≥6 were divided into two groups. Patients whose bronchoalveolar lavage (BAL) has shown the growth of more than 104 CFU/mL were included in confirmed VAP group and other patients were included in suspected VAP group. Serum and alveolar procalcitonin levels were measured and compared between both groups. RESULTS Mean age of patients was 69.10 ± 42.13 with a range of 16-90 years, out of which 23 patients were male (46%) and 27 patients were female (54%). Moreover, patients' mean clinical pulmonary infection score was reported to be 7.02 ± 1.07. There was a significant relationship between serum and alveolar procalcitonin in suspected patients and patients with an approved form of pneumonia (p = 0.001 and 0.027). Area under the curve for alveolar procalcitonin was 0.683 (sensitivity = 57%; specificity = 80%) and for serum procalcitonin 0.751 (sensitivity = 71%; specificity = 73%) for the diagnosis of VAP. CONCLUSION According to the results of the present study, we can diagnose ventilator-associated pneumonia earlier and more accurately by measuring procalcitonin level (particularly alveolar type) in intensive care unit patients.
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Affiliation(s)
- Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Roya Ghasemian
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, I.R. Iran
| | - Masomeh Bayani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Parviz Amri Maleh
- Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Masoumeh Kamrani
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Mahmoud Sadeghi-Haddad-Zavareh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
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Sharifpour A, Gholinejad-Ghadi N, Ghasemian R, Seifi Z, Aghili SR, Zaboli E, Abdi R, Shokohi T. Voriconazole associated mucormycosis in a patient with relapsed acute lymphoblastic leukemia and hematopoietic stem cell transplant failure: A case report. J Mycol Med 2018; 28:527-530. [PMID: 29807852 DOI: 10.1016/j.mycmed.2018.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Abstract
The patients with hematologic malignancies and hematopoietic stem cell transplantation (HSCT) recipients are at high risk for invasive fungal diseases (IFDs) mainly due to the severe and prolonged neutropenia related to high-dose chemotherapy. Voriconazole prophylaxis is recommended for possible IFDs. Mucormycosis is a fulminant infection, which may occur after voriconazole prophylaxis for invasive aspergillosis in immunocompromised hosts. Here, we report mucormycosis after 4 months of voriconazole prophylaxis in a young patient with relapsed acute lymphoblastic leukemia and hematopoietic stem cell transplant failure and discuss the clinical manifestation, imaging, laboratory findings and therapeutic regimens. Clinician's awareness of this entity and timely diagnosis using conventional and molecular methods are the promising approach for the management of this devastating infection.
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Affiliation(s)
- A Sharifpour
- Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - N Gholinejad-Ghadi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - R Ghasemian
- Antimicrobial Resistance Research Center, and Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Z Seifi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - S R Aghili
- Department of Medical Mycology, School of Medicine/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
| | - E Zaboli
- Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - R Abdi
- Department of Radiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
| | - T Shokohi
- Department of Medical Mycology, School of Medicine/Invasive Fungi Research Center (IFRC), Mazandaran University of Medical Sciences, Sari, Iran.
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Mobini M, Ghasemian R, Zameni F. Adult Onset Still's Disease With Different Antibodies: A Case Report and Review of Literature. Acta Med Iran 2016; 54:683-685. [PMID: 27888598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 06/06/2023] Open
Abstract
Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. There is not currently any specific serological markers for AOSD , and diagnosis still relying on the exclusion of other likely diagnoses. Yamaguchi's criteria are used as a diagnostic criterion which contains negative serologic markers for other collagen vascular diseases including systemic lupus erythematosus and rheumatoid arthritis. Here we report a 28-year-old woman with arthralgia, fever, rash, leukocytosis, lymphadenopathy, sore throat, abnormal liver function and negative rheumatoid factor and ANA but seropositive for anti-CCP, anti-dsDNA, and C-ANCA. It seems that despite AOSD is considered as a seronegativedisorder; it should be remembered in patients with compatible findings who are seropositive.
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Affiliation(s)
- Maryam Mobini
- Department of Rheumatology, Diabetes Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Roya Ghasemian
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Fatemeh Zameni
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Mazandaran, Iran
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Ghasemian R, Mostafavi E, Esmaeili S, Najafi N, Arabsheybani S. A Survey of Acute Q Fever among Patients with Brucellosis-Like and Atypical Pneumonia Symptoms Who Are Referred to Qaemshahr Razi Hospital in Northern Iran (2014-2015). Glob J Health Sci 2016. [DOI: 10.5539/gjhs.v9n4p225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
<p><strong>INTRODUCTION</strong><strong>:</strong> Coxiella burnetii is the etiologic agent of the zoonotic disease of Q fever which causes lots of morbidities and mortalities every year. The main route of human infection is inhalation of contaminated aerosols; however, consumption of contaminated dairy products is the second cause. Mazandaran province is one of the main livestock centers of the country and consumption of raw dairy in the region is quite common. There isn’t any data about Q fever incidence in this region. It seems that most cases are undiagnosed. Our main target is to prove existence of Q fever human cases in Mazandaran province. We evaluated suspect Q fever cases to demonstrate its incidence and identify the risk factors.</p><p><strong>MATERIAL </strong><strong>& METHODS</strong>: In this cross-sectional study, 56 Patients including 36 patients with brucellosis-like systemic symptoms identified by negative Wright, Coomb's Wright and 2-mercaptoethanol tests as well as 20 patients with symptoms of atypical pneumonia who did not respond to conventional therapy were enrolled. At the beginning of hospitalization and 3-4 weeks later, 10cc blood was obtained from each of 56 patients who referred for a second blood sampling. Demographic, epidemiological, and clinical manifestations of Q fever and clinical changes were completed for each patient. The samples were evaluated quantitatively in terms of the presence of phase II IgG antibodies against Coxiella burnetii by ELISA method. Acute Q fever was confirmed by line-sero conversion (change of antibody from negative to positive) or fourfold antibody rising titer in each patient. The presence of primary and secondary seropositive samples and absence of line-sero conversion (change of antibody from negative to positive) or fourfold increase in antibody titer was considered as previous infection.</p><p><strong>RESULTS</strong><strong>:</strong> The prevalence rate of acute Q fever in 56 patients with 2nd blood sample was 5.3%. There was no history of tick bite, while in 100% of cases there were risk factors such as a history of residence near animal care centers as well as a history of consumption of raw dairy products (P = 0/001). 23.2% had a previous history of Q fever infection, out of which 25.8% lived in rural areas. Among people with risk factors of keeping domestic animals, living close to animal care centers and animal abortion, the prevalence rate of previous infection was higher compared to those who did not have these risk factors.</p><p><strong>CONCLUSION</strong><strong>: </strong>Since most of the patients with acute Q fever have no specific symptom, health care providers do not suspect acute Q fever disease. In this study, it was demonstrated that infection is either directly or indirectly associated with increase in environmental risk factors including contact with livestock and its products. Our study proved that Q fever is endemic in Mazandaran province. In order to have an accurate diagnosis and proper management, clinicians should be aware of existence of this disease in the region. Because of the climate of northern Iran and easy transportation of contaminated particles, appropriate measures should be taken to control and prevent this disease.</p>
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Ghasemian R, Babamahmoodi F, Ahangarkani F. Hepatitis A Is a Health Hazard for Iranian Pilgrims Who Go to Holly Karbala: A Preliminary Report. Hepat Mon 2016; 16:e38138. [PMID: 27630729 PMCID: PMC5011296 DOI: 10.5812/hepatmon.38138] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/24/2016] [Accepted: 05/14/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Iraq is a highly endemic area for the prevalence of hepatitis A and annually hosts a large number of Iranian pilgrims, most of whom are susceptible to infection with the hepatitis A virus (HAV). OBJECTIVES This study reports the health hazard of hepatitis A for Iranian pilgrims who go to holly Karbala from the Mazandaran province. PATIENTS AND METHODS In this cross-sectional study, the data of all patients with acute hepatitis A admitted in the Razi teaching hospital from November 23, 2014 to January 24, 2015, with a history of recently returning from holly Karbala or being exposed to Karbala pilgrims, were registered. RESULTS A total number of nine patients were registered. Seven patients were male and two were female. The mean age was 30.11 ± 10.09.Two patients were from the same family. All patients had typical symptoms of acute hepatitis A. None of the patients died nor did fulminant occur in any patients. In addition, all patients were treated with supportive treatment and subsequently recovered. CONCLUSIONS This number of pilgrim patients with acute hepatitis A from a single province compels us to conduct more evaluations and follow up monitoring on all persons travelling to Karbala and be sensitive to early diagnoses of the pilgrims. In the future, it is important to be mindful of administering the HAV vaccine and Ig.
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Affiliation(s)
- Roya Ghasemian
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, IR Iran
| | - Fatemeh Ahangarkani
- Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, IR Iran
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Ghasemian R, Ahanjan M, Fatehi E, Shokri M. Prevalence and Antibiotic Resistance Pattern of Acinetobacter Isolated from Patients Admitted in ICUs in Mazandaran, Northern Iran. Glob J Health Sci 2016. [DOI: 10.5539/gjhs.v8n11p112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
<p><strong>BACKGROUND & PURPOSE: </strong>Antibiotic resistance rate is increasing in <em>Acinetobacter</em> species, especially in <em>Acinetobacter baumannii</em>, as the most important pathogen of hospital and ICU . This research aimed to evaluate antibiotic resistant rate of <em>Acinetobacter</em> spp. isolated from patients admitted to ICUs in educational hospitals affiliated with Mazandaran University of Medical Sciences.</p><p><strong>METHODS:</strong> In this cross-sectional descriptive study, 50 <em>Acinetobacter</em> isolates were collected during 2013- 2014. After confirming <em>Acinetobacter</em> species, antibacterial sensitivity test was done using disc diffusion method and minimal inhibitor concentration (MIC) was evaluated by E-test in all isolates.</p><p><strong>RESULTS:</strong> Disc diffusion method revealed that 100% of isolates were resistant to Amikacin and Cefepim and 96% were resistant to both Meropenem and Ciprofloxacin antibiotics, 6% were sensitive, 18% were intermediate and 76% were resistant to imipenem. Also, 84% of isolates were sensitive and 16% were resistant to colistin. In E-test method, 92% of isolates were sensitive and 8% were resistant to colistin. Moreover, an isolate was sensitive, one was intermediate and the remaining isolates were resistant to ciprofloxacin, and 100% of isolates were resistant to other antibiotics in E-test. Over 96% of <em>Acinetobacter</em> isolates were resistant to the antibiotics frequently used in ICU (ciprofloxacin, meropenem, amikacin, and cefepim). Colistin was found as the only appropriate antibiotic that could be used for patients in ICU.</p><p><strong>CONCLUSION:</strong> We hope these results could change the attitude of physicians toward using antibiotics in ICUs and encourage them to follow antibiotic stewardship as the only effective strategy to somewhat control antibiotic resistances.</p>
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Ghasemian R, Shokri M, Makhlough A, Suraki-Azad MA. The course and outcome of renal failure due to human leptospirosis referred to a hospital in North of Iran; A follow-up study. Caspian J Intern Med 2016; 7:7-12. [PMID: 26958326 PMCID: PMC4761116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Renal complication of leptospirosis is common and its clinical manifestations vary from urinary sediment changes to acute renal failure. The aim of this study was to determine the final outcome of renal involvement in leptospirosis. METHODS This longitudinal prospective study included all serologically confirmed cases of leptospirosis with evidence of renal failure. All patients were followed for three months while all patients with renal failure were followed-up for one year. RESULTS Fifty-one patients, 53.5±14.8 years (82.4% males) with acute renal failure were studied. Over the hospitalization period, 28 patients recovered, and seven (13.72%) patients died of multiple organ failure. At the time of discharge, 16 patients had mild renal failure. Over the follow-up period, all patients recovered but in two patients renal failure persisted at creatinine level of 1.5 mg/dl. CONCLUSION Development of renal failure in leptospirosis is not rare. Recovery of renal function may last several months. However, most patients recover completely at least after one year.
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Affiliation(s)
- Roya Ghasemian
- Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mehran Shokri
- Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Science, Babol, Iran.
| | - Atieh Makhlough
- Mazandaran University of Medical Science, Sari, Iran. ,Correspondence: Atieh Makhlough, Mazandaran University of Medical Science, Sari, Iran. E-mail: Tel: 0098 11 32207978 Fax: 0098 11 32207978
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Alian S, Davoudi A, Najafi N, Ghasemian R, Ahangarkani F, Hamdi Z. Clinical and laboratory manifestation and outcome of icterohemorrhagic leptospirosis patients in Northern Iran. Med J Islam Repub Iran 2015; 29:308. [PMID: 26913271 PMCID: PMC4764287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 10/19/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Icterohemorrhagic form of leptospirosis has a high mortality rate. In this study, the clinical manifestations, epidemiologic and laboratory findings and outcome of Weil's disease were investigated. METHODS A descriptive cross- sectional study was conducted on 66 consecutive patients with icterohemorrhagic leptospirosis who were admitted to Razi Hospital (The Therapeutic Center of Infectious Diseases in the North of Iran) in 2013. The inclusion criteria were as follows: All patients who had clinical and epidemiological data suggestive of leptospirosis and displayed icterohemorrhagic form at the time of admission or during hospitalization. All patients were visited on admission, one, two and six weeks later. Demographic data, clinical, laboratory features and complications were evaluated, and statistical analysis was performed using SPSS version 13.0. RESULTS Among 66 patients, 89.4% (n = 59) were male, 60% (n = 40) were farmers and 9.1% (n= 6) had a history of swimming in rivers. The most common complaints were fever and jaundice, respectively. The most common clinical symptoms were fever (90.9%), myalgia (75.8%), chills (70.8%) and headache (65.1%). Hyponatremia and hypernatremia were seen in 7.6% and 72.8% of the participants, respectively. Also, hypokalemia was observed in two patients (3%). Approximately, half of the cases had leukocytosis and 90% had thrombocytopenia. Rise of AST, ALT, ALP and bilirubin were seen in 95.2%, 93.6%, 76.2% and 100% of the patients, respectively. Of the patients, 42.4% experienced complications of icterohemorrhagic leptospirosis including acute renal failure (30.3%) pneumonia (25.8%), pancreatitis (4.5%), subarachnoid hemorrhage (1.5%) and gastrointestinal bleeding (1.5%). Three cases (4.5%) died, 42 cases (63.7%) were discharged with residual effects and 52 patients (78.8%) had positive serology. CONCLUSION The most significant biochemical abnormalities were thrombocytopenia, hyperbilirubinemia, hyponatremia and hypernatremia and azotemia and the latter remained stable in 2% of the patients at least until the end of the 6-week period.
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Affiliation(s)
- Shahriar Alian
- Assistant Professor, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Alireza Davoudi
- Assistant Professor, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Narges Najafi
- Associate Professor, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Roya Ghasemian
- Associate Professor, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Fatemeh Ahangarkani
- MSc, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamdi
- General Practitioner, Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran.
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Harbin AC, Bandi G, Vora AA, Cheng X, Stanford V, McGeagh K, Murdock J, Ghasemian R, Lynch J, Bedell F, Verghese M, Hwang JJ. Does pure robotic partial nephrectomy provide similar perioperative outcomes when compared to the combined laparoscopic–robotic approach? J Robot Surg 2013; 8:23-7. [DOI: 10.1007/s11701-013-0414-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/17/2013] [Indexed: 01/20/2023]
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Alian S, Ajami A, Ghasemian R, Yadegarinia D. Age-specific seroprevalence of hepatitis A in Sari, northern Islamic Republic of Iran. East Mediterr Health J 2012; 17:754-8. [PMID: 22256409 DOI: 10.26719/2011.17.10.754] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The declining incidence of hepatitis A virus (HAV) infection in the Islamic Republic of Iran may be reducing the population's natural immunity. This was the first systemized, population-based survey of the seroprevalence of HAV antibodies in urban and rural inhabitants of Sari, Mazandaran province. Serum from 1034 individuals aged 1-25 years in 2007 were tested for anti-HAV lgG antibody using a commercial enzyme immunoassay kit. The overall seroprevalence was 38.9%. The lowest prevalence (5.2%) was among the younger age group (1-5 years) from urban areas and the highest prevalence (82.0%) in the older age group (15-25 years) from rural areas. Seropositivity was significantly higher at higher age, among females and in rural areas. Sari is no longer classified as an area of high endemicity, and immunization against HAV may be needed in our population in the future.
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Affiliation(s)
- S Alian
- Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Islamic Republic of lran
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Babamahmoodi F, Davoodi AR, Ghasemian R, Delavarian L. Report of two rare complications of pandemic influenza A (H1N1). J Infect Dev Ctries 2012; 6:204-7. [PMID: 22337853 DOI: 10.3855/jidc.1723] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 02/01/2011] [Accepted: 02/08/2011] [Indexed: 10/31/2022] Open
Abstract
Novel influenza A (H1N1) has created a major worldwide health problem within a short time after its emergence. This infection is often self-limited, but sometimes can cause severe and fatal complications. In this study, we present two rare complications of pandemic influenza A, who were referred to Razi University Affiliated Hospital in northern Iran. The first case was a 30-year-old man with severe headache and high fever accompanied with chills, generalized myalgia, and arthralgia. Cerebrospinal fluid analysis was consistent with aseptic meningitis. The second case, a 25-year-old pregnant woman with high fever, chills and severe fatigue and malaise, developed tachypnea, tachycardia, respiratory distress, cyanosis and loss of consciousness a few hours after admission. Echocardiography reported myopericarditis. The patient was transferred to the intensive care unit and mechanical ventilation was begun. The next day, the patient started vaginal bleeding which progressed to spontaneous abortion three days later. Diagnosis of novel influenza A (H1N1) was confirmed using real-time reverse-transcriptase PCR of a pharyngeal swab.
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Affiliation(s)
- Farhang Babamahmoodi
- Department of Infectious Disease, Ghaemshahr Razi Hospital, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Ghasemian R, Najafi N, Makhlough A, Khademloo M. Frequency of nasal carriage of Staphylococcus aureus and its antimicrobial resistance pattern in patients on hemodialysis. Iran J Kidney Dis 2010; 4:218-222. [PMID: 20622310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Staphylococcus aureus is currently the most common cause of infection in hospitalized patients. Patients on hemodialysis are at increased risk due to their immunocompromised state. The present study was designed to determine the frequency of S aureus nasal carriage in patients on hemodialysis. MATERIALS AND METHODS This study was undertaken in 2 dialysis centers to establish the frequency of S aureus nasal carriage at teaching hospitals of Mazandaran University of Medical Sciences, in the north of Iran. Standardized nose swabs were rotated into the anterior nares of the patients, and the samples were cultured on a blood-agar medium. Having grown the colony, gram stain, catalase, manitol, DNAase, and coagulase tests were all performed. Pattern of antibacterial sensitivity was determined by using the disc diffusion method. Also, agar dilution method was used to determine minimal inhibitory concentration of oxacillin and vancomycin. RESULTS Of 84 patients on hemodialysis, 31 (36.9%) were nasal carriers of S aureus, of whom 23 (74.2%) were resistant to methicillin. Of the methicillin-resistant S aureus isolates, 3 (13.0%) were resistant to vancomycin and 7 (56.5%) had reduced susceptibility to vancomycin in agar dilution method. Resistance frequencies to clindamycin, ciprofloxacin, and trimethoprim-sulfamethoxsazole were 12.9%, 9.7%, and 19.3%, respectively. However, all microorganisms were sensitive to rifampicin. CONCLUSIONS Patients on hemodialysis are at an increased risk of S aureus infections; thus, screening of these susceptible patients should be considered as a health priority. Meanwhile, microbial sensitivity tests should be ordered for all cases in order to optimize treatment options.
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Affiliation(s)
- Roya Ghasemian
- Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
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Ghasemian R, Najafi N. Knowledge and Performance Toward Universal Precautions Among Nurses in University-Affiliated Hospitals of Mazandaran, Iran. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ghasemian R, Najafi N. General Practitioners and Medical Student's Knowledge and Perspectives Regarding Influenza (Treatment and Prevention). Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
This study reports results from a 60-month study on the use of TCu380A IUD among 400 women in Sari, Iran. The aim of this study was to assess a sample of women in our region who requested removal of their IUD, continuation rates use and reason for discontinuation. This is a cohort study on 400 women who using the TCu380A IUD and referred to medical health centers of Sari/Iran from May 1999 to May 2006. We randomly selected one half of all health and medical centers in Sari (a total of 20 centers). At each selected center, we randomly sampled 10% of all IUD subjects whose insertion occurred between May 1999 and May 2006. Obtained data were analyzed by descriptive statistical methods. Continuation rates at the end of 1, 2, 3, 4 and 5 years were 96.3, 81.5, 79.2 and 18 per 100, respectively. Median survival time was about 37 months. Among women using the TCu380A IUD, the rate of termination due to bleeding was significantly higher than the rate of termination due to other causes. These findings indicate that family planning educators and health care providers should give more emphasis to counseling programs for women desiring IUD insertion and during follow-up.
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Affiliation(s)
- Mohamad Khademloo
- Department of Community Medicine, Mazandaran University of Medical Sciences, Iran
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Delone P, Corkill J, Jordan M, Krapiva P, Ghasemian R, Sasaki T, Light JA. Successful treatment of Epstein-Barr virus infection with ganciclovir and cytomegalovirus hyperimmune globulin following kidney transplantation. Transplant Proc 1995; 27:58-9. [PMID: 7482823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- P Delone
- Department of Transplantation Services, Washington Hospital Center, Washington, DC 20010, USA
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