Showing 18 results for Emadi
H Etemadi , Sh Zahedani ,
Volume 54, Issue 1 (30 1996)
Abstract
Hospital acquired infection have 2 origins: 1) Infections acquired from the hospitalization. 2) Infections that transmit from hospital personnel and those who referred to a hospital. According to the studies approximately half of hospital acquired infection is under the first group. Gram-negative bacilli is of prime importance from all bacteries that caused hospital acquired infection. There are 3 main ways spreading hospital acquired infections include: 1) Auto infections 2) Transmit infections 3-environmental infections. In addition, three following factor's will help to cause hospital acquired infections. 1) Reduced immunologic defenses in patient. 2) Local reducing of immunologic defense. 3) Hospital pathogens. From 7/7/1367 to 30/3/1368 samples from patients were collected from 4 hospitals. Then with use of microbiological methods, identified pathogenic organisms
Samar G, Hajy Abdolbaghy M, Ahmadi Nejad Z, Emadi H, Emadi J,
Volume 59, Issue 3 (8 2001)
Abstract
Typhoid fever is an endemic disease in Iran and other developing countries. This disease has gradually become resistant to the first line of drugs, and because of this resistancy we have studied a new alternative drug (cefixime) on typhoid fever patients and compared it's effectiveness with chloramphenicol. For this purpose, by a randomized clinical trial in Emam Khomeini hospital between 1995-2000, we allocated 44 uncomplicated patient with established typhoid fever (positive blood or bone marrow culture) and by random selection, 24 patient were given cefixime (400 mg PO bid) and 20 patient received chloramphenicol (500 mg po Q6h). The duration of therapy were 10 and 14 days for chloramphenicol and cefixime group respectively. Median fever clearance times were 5±1.9 for cefixime recipients and 3.8±1.2 days for chloramphenicol treated patients, but for improvement in other clinical and laboratory findings, there were not any significant difference. Bacteriologic and clinical cure rate for cefixime was 100 and 92 percents respectively. Though, even cefixime like other betalactam drugs is slow in helping the fever disappearance but our study suggests that oral cefixime is effective and can be used as an alternate treatment of typhoid fever.
Azizi F, Etemadi A, Salehi P, Zahedi Asl S,
Volume 61, Issue 5 (15 2003)
Abstract
The aim of the present investigation was to determine the prevalence of metabolic syndrome.
Materials and Methods: Metabolic syndrome was defined by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose.
Results: In this study, 10368 of the adults (4397 men and 5971 women) aged 20 years and over, participated in Tehran Lipid and Glucose study. The unadjusted prevalence of metabolic syndrome in the study population was 30.1% (CI 95%: 29.2-31.0), and age-standardized prevalence was 33.7% (CI 95%: 32.8-34.6). The prevalence increased with age in both sexes. Metabolic syndrome was more commonly seen in women than men (42% vs. 24%, p< 0.001). Low HDL-C was the most common metabolic abnormality in both sexes. Except for high FPG, all abnormalities were more common in women than in men (p< 0.001). Most of those with metabolic syndrome had 3 components of the syndrome (58%), 33% had four, and 9% had five
components.
Conclusion: This first report on metabolic syndrome from Iran shows a high
prevalence of this disorder, imposing serious impacts on health care system. Efforts
on promoting healthy diets, physical activity, and blood pressure control must be
undertaken.
Emadi Koochak H, Yalda A R, Haj Abdolbagh M, Sood Bakhsh A,
Volume 61, Issue 5 (15 2003)
Abstract
Crimean-Congo hemorrhagic fever (CCHF) was first described in the Crimea in 1944 and then in 1956 in congo. CCHF is a viral hemorrhagic fever of the Nairovirus group that belongs to Bunyaviridae family virus. It is transmitted to human by tick bite. The most efficient and common tick that is the vectors of CCHF is a member of the Hyalomma genus which infected many mammals such as livestock, this tick is the main reservoire of virus in nature. Humans also become infected with CCHF virus by direct contact with blood or other infected tissues from livestock or human patients (nosocomial infection). Disease has been found in saharic Africa, Eastern Europe, Pakistan, India and Middle East (specially Iran and Iraq). This disease recently spread in Iran so in 1999 to 2001 at least 222 suspected case(81 definite case) reported that led to the death of 15 of 81 cases. It is estimated that 30 percent of the country's cattle are contaminated with this virus.
In humans, after a short incubation period it appears suddenly with fever, chills, myalgia and GI symptoms followed by severe bleeding and DIC that led to death .If the patient improved, has a long {2-4 weeks) convalescence period. Disease diagnosed by clinical manifestations, serologic tests, viral culture and PCR and its specific treatment is oral ribavirin for 10 days, for prevention of disease personal protective measures from tick bite, spraying poison of mews to reduce of ticks crowd, isolation of patients and dis-infection of contaminated personal equipments that who suffering from CCHF is recommended.
G Tarighat Saber, S Zarei, A Etemadi, Mr Mohammadi , G Shams,
Volume 64, Issue 2 (30 2006)
Abstract
Background and Aim: Anxiety is the most common psychological distress in cancer patients. Many studies have been conducted to assess the prevalence of anxiety and depression and the predisposing factors of psychological morbidity in cancr patients. Patients knowledge of disease, their desire for more information, their satisfaction of given information and their attitudes’ towards communication of information about cancer are among issues that have not been well anddressed in assessment of psychological morbidity of cancer patients in Iran.
Materials and Methods: 250 cancer patients of 15-75 age group who were referred to Cancer Institute entered the study. The patients’ knowledge of disease, their desire for more information, their attitude and satisfaction were assessed by Questionnaire n1. patients’ anxiety and depression scores were assessed by Hospital Anxiety and Depression Scale (HADS).
Results: 30 of patients had severe anxiety symptoms and 17% suffered severe depression most patients’ knowledge of disease was “low” (32%) and “intermediate” (54%). There was no significant correlation between knowledge and anxiety and depression. Most patients (69%) believed that the information given by physicians had been “insufficient”. Depression score was significantly higher in this group of patients compared to other patients. Most patients (59%) had a high level of desire for gaining more information and 64% believed that physicians should inform patients of different aspects of disease as much as possible. There was no significant correlation between patients’ desire and attitude and anxiety and depression. Level of satisfaction was “low” in 29% of patients and “intermediate” in 39%. Depression and anxiety scores were significantly higher in patients who were less satisfied with given information.
Conclusion: Low level of knowledge in most cancer patients, their high desire for gaining more information, their dissatisfaction of given information and their positive attitudes towards full disclosure of information about cancer in this study, all indicate that complete and honest disclosure of information to cancer patients by physicians should be improved and encouraged. Although it seems that amount of information given doesn’t influence the psychological morbidity in cancer patients the patients’ satisfaction of given information, which has implications for the quality of patient-physician communication, plays a far more important role in occurance of psychological morbidity in cancer patients. Meanwhile, negative public opinion of cancer and its prognosis greatly influences the physicians functions and the quality of communication process, and also has negative effects on cancer patients’ psychological adjustment.
A. Yalda, H. Emadi1, M. Haji Abdolbaghi,
Volume 64, Issue 4 (1 2006)
Abstract
The purpose of this paper is to provides general information about avian influenza (bird flu) and specific information about one type of bird flu, called avian influenza A (H5N1), that has caused infections in birds in Asia and Europe and in human in Asia. The main materials in this report are based on the World Health Organization (WHO) , world organization for animal health (OIE) , food and agriculture organization of the united nations (FAO) information and recommendations and review of the published literature about avian influenza. Since December 2003, highly pathogenic H5N1 avian influenza viruses have swept through poultry populations across Asia and parts of Europe. The outbreaks are historically unprecedented in scale and geographical spread. Their economic impact on the agricultural sector of the affected countries has been large. Human cases, with an overall fatality rate around 50%, have also been reported and almost all human infections can be linked to contact with infected poultry. Influenza viruses are genetically unstable and their behaviour cannot be predicted so the risk of further human cases persists. The human health implications have now gained importance, both for illness and fatalities that have occurred following natural infection with avian viruses, and for the potential of generating a re-assortant virus that could give rise to the next human influenza pandemic.
Hadadi A, Afhami Sh, Kharbakhsh M, Hajabdoulbaghi M, Rasoolinejad M, Emadi H, Esmaeelpour N, Sadeghi A, Ghorashi L,
Volume 65, Issue 9 (3 2007)
Abstract
Background: Health care workers (HCWs) are at substantial risk of acquiring bloodborne pathogen infections through contact with blood and other potentially infectious materials. The main objectives of this study were to determine the epidemiological characteristics of occupational exposure to blood/body fluids, related risk factors of such exposure, and hepatitis B vaccination status among HCWs.
Methods: This cross-sectional study was conducted from December 2004 to June 2005 at three university hospitals in Tehran, Iran. Using a structured interview, we questioned HCWs who had the potential for high-risk exposure during the year preceding the study.
Results: With a total number of 467 exposures (52.9%) and an annual rate of 0.5 exposures per HCW, 391 (43%) of the 900 HCWs had at least one occupational exposure to blood and other infected fluids during the previous year. The highest rate of occupational exposure was found among nurses (26%) and the housekeeping staff (20%). These exposures most commonly occurred in the medical and emergency wards (23% and 21%, respectively). The rate of exposure in HCWs with less than five years of experience was 54%. Percutaneous injury was reported in 280 participants (59%). The history of hepatitis B vaccination was positive in 85.93% of the exposed HCWs. Sixty-one percent had used gloves at the time of exposure. Hand washing was reported in 91.4% and consultation with an infectious disease specialist in 29.4%. There were 72 exposures to HIV, HBV and HCV exposure to HBV was the most common. In 237 of the enrolled cases, the source was unknown. Job type, years of experience and hospital ward were the risk factors for exposure.
Conclusion: Education, protective barriers and vaccination are important in the prevention of viral transmission among HCWs.
Mohammadi M, Mirjalili A, Habibi Gh, Falahi Sh, Sarafnejad A, Eatemadi A, Boutorabi Sm,
Volume 67, Issue 1 (4 2009)
Abstract
Background: Anti-dsDNA antibodies frequently found in the sera Systemic Lupus Erythematosus patients, particularly in active disease stage. Nowadays exploit different eukaryotic and prokaryotic dsDNA as antigen source and different reagents as binder. The aim of this study to compared two dsDNA different sources and tow different kinds of reagents for binder in ELISA test.
Methods: In this study bacterial genomic DNA from E.coli (ATCC 25922) and genomic DNA from calf thymus extracted with high purity and were used as antigens for IgG anti-dsDNA detection by ELISA. To coat dsDNA in microtiter wells, tow different kinds of reagents including methylated -BSA and poly-l-lysine (for pre-coating) are used. Sera from systemic lupus erythematosus patients and from normal blood donors are used to assess sensitivity and specificity of our ELISA test in compared with IF test and commercial kits.
Results: Our results displayed pre-coating of microtiter plates with methylated -BSA reduce nonspecific binding reaction and the relative sensitivity and specificity of ELISA increased when calf thymus DNA is employed as antigenic source in compared with IF test and commercial kits 80%, 88% and 100%, 98% respectively, but when E.coli DNA is used 73%, 69% and 85%, 79%, respectively.
Conclusion: The genomic DNA from calf thymus is a potentially useful source of antigen for detection of anti-dsDNA by ELISA. Also the use of methylatted- BSA could have an effective role in reducing of nonspecific binding reactions.
Abdolreza Soudbakhsh , Habibollah Mortazavi , Mahbobeh Hajiabdolbaghi , Mehrdad Hasibi , Sirous Jafari , Hamid Emadi Kochak, Esmaili Djavid,
Volume 67, Issue 6 (9-2009)
Abstract
Background: Finding a reliable diagnostic method for brucellosis is the most challengeable problem. In this study we determined the optimal diagnostic cut-off point for ELISA test.
Methods: We gathered 56 confirmed cases of brucellosis. Furthermore blood samples from 126 controls including 73 healthy controls and 53 without brucellosis febrile patients were collected. In all of the cases and controls ELISA Ig G and ELISA Ig M levels were measured and compared with each other by Box plot graph and the Receiver Operating Characteristic (ROC) curve. The sensitivity and specificity of ELISA Ig G and Ig M were fixed in different cut-off values and Ig G and Ig M levels yielding maximal sensitivity plus specificity were selected for determination of optimal cut-off point.
Results: The nineteen patients had positive blood cultures for Brucella melitensis. The standard agglutination test results were 1/160 or more in 54 patients. The Box plot graph indicated a high degree of dispersion for Ig G and Ig M data in patients with brucellosis compared with febrile patients without brucellosis and healthy controls. We observed partial overlap for Ig M data (not for Ig G) between cases and controls. The area under ROC curve for discrimination of cases and healthy controls was more for Ig G than Ig M.
Conclusions: The ELISA Ig G is more reliable test than ELISA Ig M in diagnosis of brucellosis. Using cut-off of 10 IU/ml and 50 IU/ml have the most sensitivity (92.9%) and specificity (100%) for ELISA Ig G test, respectively.
Rohollah Rohollah , Seyed Hotan Alavi , Mohsen Arayeshkha , Majid Emadi ,
Volume 67, Issue 6 (9-2009)
Abstract
Jafari S, Rasoolinejad M, Emadi Kouchak H, Mokarami F,
Volume 67, Issue 7 (7 2009)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: CD4 T-Lymphocyte counts have proven to be a standard
laboratory marker of disease progression and severity of immunodeficiency in
adults infected with HIV is used to initiate and monitor highly active
antiretroviral therapy however, its application may not be feasible for its
expensive equipments and reagent in resource-limited setting. There is a need
to have another marker of immunodeficiency that is less resource-demanding. In
April 2002, the World Health Organization (WHO) recommended that, when CD4 cell count is not available, a
TLC of
1200cell/mm3
or less in individuals with stage 2 or 3 of the disease may be used as an indication to
initiate ART.
Methods: The aim of this study was to determine the
relationship between total lymphocyte count and CD4 count in HIV-infected
adults. This was a retrospective cross-sectional study. Subject characteristics
were patients who had positive serologic HIV test results, confirmed via western blot. Analysis unit was the
results of CBC and CD4 measurements on the same blood sample each time. Data
of 100
patients were collected. In this study, TLC accounts for the main predictor of CD4 count. The
amounts of TLC which can predict CD4 less than 200cell/mm3 were considered eligible.
Results: Our data revealed high sensitivity and specificity of TLC as a surrogate
measure of CD4 count. In this study, TLC cutoff of 1300cell/mm3 indicated the optimal combined sensitivity and specificity altogether.
Conclusion: Total lymphocyte count and its changes can be used as
alternative to CD4
count and its changes in the management of HIV-infected individuals.
Masood Etemadifar, Mehrdokht Mazdeh, Hamid Reza Torabi, Majid Ghaffarpour, Mojtaba Azimian, Shiva Salami, Sayyed Mohammad Amir Shahkarami,
Volume 68, Issue 1 (4 2010)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4
Background: Recent studies present a
high prevalence of multiple sclerosis (MS) in Iran. Treatment with interferon is now the first choice in management
of MS. CinnoVexTM (an interferon beta 1-a) is available in
Iran, with achievement of the technology of producing beta interferon. The aim of
the present study is to evaluate the efficacy and safety of CinnoVexTM in a national study named CINA study.
Methods: This study was conducted from 2007 to 2008 in cities of Tehran, Isfahan, Mashhad,
Tabriz, and Shiraz. Patients with relapsing/remitting MS with 16-50 years of age and EDSS of <4 received CinnoVexTM (30µg/week, IM) after diagnosis by a neurologist. EDSS, drug side effects, and frequency of relapse were evaluated for one year
in four 3-month visits.
Results: A total of 1050 patients entered the study. Complete data
were collected from 627 (60%) patients. Mean age was 30.7±8.6 year and 514 (82%) were female. The most common onset presentations
were sensory symptoms (44%). Changes of EDSS through the study showed a significant decrease in the last 3-month of evaluation (p<0.05). Drug side effects
were observed in 47%, 50%, 61%, and 61.4% (p>0.05) and relapse was occurred in 13.4%, 15.7%, 16.9%, and 2.4% of the patients in the first, second, third,
and forth evaluation visits (p=0.001), respectively.
Conclusion: CinnoVexTM prevents progression and improves clinical course of MS. The conventional side
effects of beta interferon therapy, however, are observed with CinnoVexTM.
Rasoulinejad M, Bouyer M, Emadi Kouchak H, Hasibi M, Mollazadeh N, Moradmand Badie B,
Volume 68, Issue 10 (5 2011)
Abstract
Background: Tuberculosis with high prevalence in HIV/AIDS
patients is the main reason for morbidity and mortality in these patients.
About one-third of patients with HIV infection
have concomitant tuberculosis. Lack of appropriate infection control on many
social and economic communities will impose. Comprehensive study on the effects
of anti-tuberculosis drugs in patients with HIV infecting
less done, also due to the importance of reducing morbidity and mortality,
reduce the cost of disease, identifying drug pharmacokinetics, the importance
of completing treatment tuberculosis, this study was performed to evaluate the
effects of anti- tuberculosis drugs on HIV infection
and to identify the drug pharmacokinetics and so more complete tuberculosis
treatment.
Methods: A historical cohort study was performed on
patients referring to the research center for HIV/AIDS,
consultation center, department of infection diseases of Imam
Khomeini Hospital
in Tehran, Iran. A
total number of 75 cases with HIV
negative versus HIV positive patients
with pulmonary tuberculosis and positive sputum smear in accordance with
inclusion and exclusion criteria were selected.
Results: In this study, the frequency of peripheral neuropathy 27(73%),
arthralgia 31(83.8%), vomiting 18(48.6%),
headache 26(70.3%), dizziness 20(54.1%),
renal toxicity 4(10.8%) and of skin rash 10(27%)
in patients with HIV virus infection were
significantly more than HIV- negative patients.
Hepatotoxicity, fever and anemia were not significantly more common in patients
who infected with HIV virus.
Conclusion: The HIV patients, who have not received antiretroviral
drugs during tuberculosis treatment, may show higher incidence of
anti-tuberculosis drugs complications.
Mahmood Motamedi , Mohammad Reza Ghini , Pardis Etemadi , Tayeb Ramim ,
Volume 71, Issue 9 (December 2013)
Abstract
Background: Choosing the right drug with the least side effects and highest effectiveness for the control of seizures in the elderly is important. The aim of this study was compare the efficacy of lamotrigine and levetiracetam in the management of epilepsy in the elderly.
Methods: This study was performed as a double-blind randomized clinical trial in patients that referred to the neurologic clinic at Sina University Hospital, Tehran, Iran in 2012. The patients over sixty years old with a diagnosis of epilepsy were selected. They had one seizure in year at least and one attack in the last 6 months. First, the patients divided to two groups Group one were treated with lamotrigine, 25 mg per day and group two were treated with levetiracetam, 250 mg per day for 24 weeks. In the absence of drug complications, the dose was increased to the maximum dose listed in the treatment protocol. Second the patients were followed in number of attacks, abnormalities in laboratory data and side effects of drug in 2, 4, 8, 12 and 20 weeks. The collecting data of the study were analyzed using descriptive and analytical statistics methods.
Results: Forty nine cases, 28 males and 21 females in lamotrigine group and 46 cases in levetiracetam group, 27 males and 19 females participated in the final analysis. Mean age of patients was 72.40±5.87 (63-85). Drug side effects were observed in 57 cases, 26 cases of lamotrigine group and 31 cases of levetiracetam group. Seizure frequency showed a declining trend in both groups but in lamotrigine group more than levetiracetam group in last week (P= 0.039).
Conclusion: The findings of the study showed lamotrigine and levetiracetam were effective in management of epilepsy in the elderly. Levetiracetam has a higher seizure-free effect than lamotrigine but lamotrigine is better tolerated than levetiracetam.
Mahboobeh Haji-Abdolbaghi , Mehrnaz Rasoolinejad , Laden Abbasian , Aliakbar Amir Zargar, Hamid Emadi Koochak, Pardis Moradnejad, Naseh Mohammadi , Ali Pashae Zanjani , Saeed Bayanolhagh , Parisa Sadr Poor,
Volume 72, Issue 1 (April 2014)
Abstract
Background: Abacavir is an anti-retroviral medication used to treat HIV infected/AIDS patients and its efficacy has been proven in randomized clinical trials. The most significant adverse reaction associated with abacavir is the acute hypersensitivity phenomenon which manifests in many forms and in severe cases could result in death. Hypersensitivity reaction to abacavir has been closely linked to the presence of HLA-B*57:01 allele. Avoidance of abacavir initiation in allele-positive patients is the most effective strategy in preventing possible severe hypersensitivity reactions. Previous epidemiologic studies have made great strides toward delineating HLA-B*57:01 allele frequency in different regions of the World and the available results indicate significant discrepancy between geographical regions. Despite these efforts, no study to date has determined the allele frequency among Iranian HIV-positive patients. The aim of the present study was to determine the proportion of allele-positive patients among a group of Iranian HIV-infected patients.
Methods: Between September 2012 and February 2013, 122 HIV-positive patients were selected among patients referred to Imam Khomeini Hospital’s Consultation cen-ter for high risk behaviors using the convenience sampling method. Sampling scheme was designed in a manner to include equal number of infected patients with and without clinical Acquired Immunodeficiency Syndrome (AIDS). Patient data was collected using available records and a blood sample for DNA analysis was also obtained. Presence of HLA-B*57:01 allele was determined using the Polymerase Chain Reaction- Sequence Specific Method (PCR-SSP).
Results: Seventy three patients (59.8%) were male. Co-infection with hepatitis B and C was observed in 1.7% and 40.7% of the patients, respectively. History of addiction and anti-retroviral therapy was positive in 50.0% and 60.7% of the patients, respectively. Overall, three patients were allele-positive which corresponds to a frequency of 2.46% (95% CI: 0.005-7.30). No association between presence of allele and investigated vari-ables were identified.
Conclusion: Frequency of HLA-B*57:01 allele among a group of Iranian HIV-infected patients is estimated to be 2.5%. This rate is comparable to those reported in other Middle-Eastern countries, yet is relatively lower than reports generated from South-Eastern Asia, Europe, and the United States. Future studies with larger sample sizes are needed to corroborate these findings.
Mahboobeh Hajabdolbaghi , Hamid Emadi Kochack , Mohammad Reza Salehi , Seyed Ali Dehghan Manshadi, Mehdi Usefipour , Afsaneh Motevalli Haghi ,
Volume 73, Issue 4 (July 2015)
Abstract
Background: One of the main reasons of hemorrhagic fevers is Ebola. The high rate of mortality and lack of definite treatment have been caused this infection to be a serious problem in the world. Ebola, especially in the early stages, when causes symptoms such as fever, anorexia and nausea, can be confused with malaria infection and conversely, severe malaria with Ebola. Plasmodium falciparum is an important cause of severe malaria that more than other types of plasmodium confused with Ebola.
Case presentation: The patient is a 54-year-old man who had gone to Sudan about 8 months ago. The patient reported that fever, chills and headache had been started one week before traveling from Sudan to Iran and hematuria was added to his symptoms in third week of illness in Iran. He was referred to the emergency department with probable diagnosis of Ebola. Plasmodium falciparum gametocytes were revealed in his peripheral blood smear. Finally, he was treated with Coartem (artemether/lumefantrine) for malaria and after clinical improvement discharged to home with good condition.
Conclusion: Ebola should be suspected in every patient with fever and a history of traveling to endemic areas. Considering the fact that in most areas where Ebola is endemic also malaria is common, lack of clinical suspicion to malaria causes that clinicians mistake malaria with Ebola. Necessary laboratory tests to rule out important differential diagnoses in patients with suspected Ebola virus contains: Peripheral blood smear for malarial parasite and blood culture and blood cell counts to investigate typhoid fever and other bacterial infections. Therefore, malaria should be considered as an important differential diagnosis in every patient suspected with Ebola.
Shirinsadat Badri , Sara Etemadi-Moghaddam , Azadeh Moghaddas ,
Volume 77, Issue 12 (March 2020)
Abstract
Background: Amphotericin B is one of the most useful therapeutic modalities for the treatment of patients with invasive fungal infections, in spite of serious side effects, namely kidney injury, electrolyte imbalances, and infusion-related reactions. The goal of this study was to assess the different aspects of premedication practice and the incidence and types of infusion-related reactions in patients receiving amphotericin B.
Methods: This observational study was performed on 70 hospitalized patients who received amphotericin B in different departments of two university hospitals, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, from January 2017 to February 2018. Information on physicians’ performance regarding premedication administration for amphotericin B, including the types and doses of medications administered prior to amphotericin B infusion, as well as patients’ clinical data including infusion-related side effects were collected and then analyzed in comparison with the standard practice guidelines.
Results: The study population consisted of 70 patients with the mean age of 51.6±18.3 years, who received amphotericin B for 8.2±3.5 days. From 70 evaluated patients, 21 patients (30%) had encountered the infusion-related reactions, including chills, fever, urticaria, headache, and hypotension. These side effects were evident in 19 patients (27%) who received no premedication and 2 patients (3%) who received only one drug as premedication, before amphotericin B administration. Twenty patients (28%) experienced chills, fever and headache, while 7 patients (10%) had nausea and vomiting during amphotericin B infusion. Hydrocortisone 50-200 mg, was the most prescribed agent for premedication (in 67% of patients), while chlorpheniramine 10 mg (in 50% of patients) and promethazine 10 mg (in 35% of patients) were the second and third prescribed ones, respectively.
Conclusion: In this study, the patients who received no or only one drug as premedication experienced infusion-related side effects. This emphasizes the necessity for standard premedication practices to prevent this type of adverse reactions. Considering the higher price of liposomal form of Amphotericin-B, if prescribed correctly, even the conventional form would be an effective and tolerable treatment for invasive fungal infections.
Maryam Tajvar, Amirhossein Mortezaei, Ali Sadeghinia, Seyed Naser Emadi , Zeinab Khaledian,
Volume 80, Issue 5 (August 2022)
Abstract
Background: Vitiligo is a multifactorial acquired disorder characterized by the complete or partial destruction of skin melanocytes in the affected areas. Vitiligo affects the personal and social life of patients negatively and causes defects in their quality of life. Since the role of psychological factors in some skin diseases and chronic disorders has been identified, the present study was conducted to understand the possible role of psychological stress in the incidence of vitiligo disease.
Methods: This is a Retrospective Case-Control Study that was conducted in the Razi hospital affiliated with Tehran University of Medical Science in 2021. Razi hospital is a specific referral center for dermatologic disorders. In this study, 87 patients with onset of vitiligo not more than 3 years before evaluation (case) were compared with 130 patients affected by other skin disorders with a well-established etiology (control). Participants were selected through convenience sampling from August to February. They were studied for experienced stressful life events during the year before the diagnosis. To understand this, we utilized a validated Stressful life events (SLE) Questionnaire. Additionally, we probed a clinical record, to demographic and socioeconomic characteristics, medical history, and clinical status of the disease. The data were analyzed in SPSS version 23 with descriptive and analytical statistics.
Results: The incidence of the vitiligo disease by controlling socioeconomic confounders, was related to experience of stressful life events in past year (OR=1.89, CI=95%, P=0.01). The chance of developing vitiligo increased by 89% per each unit increase in the mean of stressful event. Also, an increase in personal conflicts (OR =2.23, P= 0.00), Educational concerns (OR=1.94, P=0.00), job security (OR=1.28, P=0.03) and family life (OR=1.57, P=0.03) significantly (95% CI) increased the chance of developing vitiligo disease. While for other events were not significantly different between the two groups.
Conclusion: stress plays a significant role in vitiligo disease as a causal factor. So, Psychosocial intervention should be considered in preventing and treatment of disease.
