Showing 10 results for Hajiabdolbaghi
Rassulinejad M, Hossami Roodsari H, Mahdavi Mazdeh M, Hajiabdolbaghi M, Ahmadi F L,
Volume 61, Issue 6 (15 2003)
Abstract
Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences.
Materials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran.
Results: 164 renal transplant recipients were studied, 14 patients (8.5%) had pulmonary infection, 11 of them (78.6%) were female and 3 (21.4%) were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4%) was between 1 to 6 months post transplantation, 11 cases (78.6%) were occurred beyond 6 months after transplantation. In 7 cases (50%), pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8%) of pulmonary infection, and organism were detected in 5 of them (83.3%). The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%), this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment.
Conclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation.
M Hajiabdolbaghi, A.a Amirzargar, M Khaledi, F Khosravi, M Rasoolinejad, Z Ahmadinejad, A Soodbakhsh, S Gafari, B Ansaripoor , B Nikbin,
Volume 64, Issue 2 (30 2006)
Abstract
Background and Aim: The better understanding of immunopathologic mechanism of tuberculosis (TB) is necessary for the production of new vaccines and adjunctive immunomodulator drugs. Intended to this object, the following study including the measurement of serum concentrations of Th1 (Interferon (IFN)-y and interkeukin (IL)-2 and Th2 cytokines(IL-4AND IL-10 ) in patients with sputum smear-positive pulmonary TB and comparisons of them with PPpositive healthy persons, was designed.
Materials and Methods: The HIV-negative patients that had sputum smear-positive pulmonary TB as defined WHO criteria and hospitalized in the infectious diseases ward of Imam Khomeini hospital or referred to health care centers in the south of Tehran, were included in the study. The PPD-positive healthy persons who were close contacts with pulmonary TB patients, were considered as control group.
Results: In this research 34 active pulmonary TB patients (including17men and 17 woman)and 23 healthy persons with PPD skin test results or = 10mm (including 12men and 11 woman) were studied. The mean ages of the patients and the healthy persons were 73 and 41 years and 74 and 27 years, respectively. The mean serum IFN-Y concentration was significantly higher in TB patients but the mean serum IL-2 IL-4and IL-10 concentrations were significantly higher in healthy persons. The com parison of the mean serum levels of these cytokines before and during treatment (about 2 months after starting treatment) showed that the amounts of IFN-y and IL4 were increased and the amounts of IL2 and IL-10 were decreased but only the changes of IL-10 were statistically significant. There were no effect on the cytokine changes before and during treatment by age and gender of the patients.
Conclusion: The results of the study of serum Th1 and Th2 cytokines in pulmonary TB patients were different in comparison with the results of the studies of peripheral blood mononuclear cells (PBMCs) stimulated with M.tuberculosis antigens. SO, the simultaneous measurement of them in serum, pleural fluid, BAL fluid and the medium culture of PBMCs stimulated with the antigens is recommended.
Z Ahmadinejad, Sh Phyroosbakhsh, Z.n Hatmy, B Bagherian, H Sabery, M Bahador, M Nikzad, M Jamali Zavare, A Hadady, M Hajiabdolbaghi, M Mohraz, M. Rasolinejad, A Soudbakhsh, A Yalda,
Volume 64, Issue 2 (30 2006)
Abstract
Background and Aim: Tuberculous pleural effusion occurs in 30% of patients with tuberculosis (TB). Rapid diagnosis of a tuberculous pleural effusion would greatly facilitate the management of many patients. The purpose of this study was to determine sensitivity, specificity, and predictive values of clinical, laboratory, radiographic findings in patients with tuberculous pleural effusion.
Materials and Methods: The cross sectional study was performed between august 2002 and March 2004 at a referral teaching hospital. Major clinical, laboratory, and radiographic findings were evaluated in 88 cases of pleural effusion, 33 with confirmed TB pleural effusion (TBPE) and 55 with a diagnosis other than TB (NTBPE).
Results: The sensitivity of culture of pleural effusion and tissue were 3% and 9.1% respectively. The mean of adenosine deaminase (ADA) values in TBPE was 36.7 U/L (±18.72), and the mean in the NTBPE was 28.2 U/L (±17.0). Both the sensitivity and specificity of ADA estimation in diagnosing tuberculosis were 55%. The sensitivity of PCR was 3% with specificity of 12.7% (positive predictive value, 50% negative predictive value, 70%). Younger age (p<0.024), positive history of exposure to TB patient (p<0.02), and the combination of fever, weight loss and sweating (p<0.01), were associated with tuberculous pleural effusion. There were also significant association between Positive sputum smear (p<0.001), positive sputum culture (p<0.006), positive pleural biopsy (p<0.001), pleural LDH>200 (p<0.005), pleural lymphocytes>50% (p<0.015) and TBPE.
Conclusions: In our region with a high incidence of tuberculosis, the most frequent cause of exudative pleural effusion is tuberculosis. We suggest that the diagnostic planning of pleural effusion should be determined in each region with a view to the adoption of regionally optimized diagnostic and therapeutic facilities.
Khalili H, Gholami Kh, Hajiabdolbaghi M, Sairafipoor Z,
Volume 64, Issue 12 (6 2006)
Abstract
Background: Drug Utilization Evaluation (DUE) studies are performed to define, determine, and finally improve the quality of drug usage. These types of studies are especially valuable for drugs with a narrow therapeutic index or specific indication, or for expensive medications. In Iran, vancomycin is only available by prescription for methicillin-resistant staphylococcal and enterococcal infections. It is obvious that extensive and irrational use of this drug can increase bacterial resistance to this antibiotic. The goal of this study was to assess vancomycin utilization.
Methods: In a descriptive cross-sectional study performed during the fall and winter of 2004, this vancomycin DUE was done in the Infectious Disease Department of Imam Khomeini Hospital in Tehran. All of the patients receiving vancomycin were enrolled in this study. The Centers for Disease Control (CDC) and American Society of Hospital Pharmacists (ASHP) protocols have been used to perform this study.
Results: Of the 565 inpatients at this hospital, 39 subjects (7%) received vancomycin. Vancomycin utilization among these patients was compatible with CDC and ASHP protocols in only 28% and 35% of the patients, respectively.
Conculusion: Vancomycin is predominantly administered empirically, rather than being based on the antibiogram. This may be due to the routine protocol of the ward or the physician doubting the reliability of the antibiogram.
Hajiabdolbaghi M, Allishah H.a, Rasoolinejad M, Bahador A, Izadi M, Mobaien A.r,
Volume 65, Issue 11 (1 2008)
Abstract
Background: Tuberculosis is still one of the most important causes of mortality and morbidity in many countries and is the second only to human immunodeficiency virus as a cause of death worldwide resulting from a single infectious agent. In 1993, the World Health Organization declared tuberculosis a global public health emergency. Conven-tional methods for the diagnosis of Mycobacterium tuberculosis (MTB) infections are time consuming, as MTB culture requires 3-8 weeks for growth. To determine the sensitivity of polymerase chain reaction (PCR) in peripheral blood mononuclear cells (PBMC), we have evaluated Mycobacterium tuberculosis DNA in peripheral blood samples with PCR technique in adults with new cases of pulmonary and extra-pulmonary tuberculosis. Setting: Department of Infectious disease of Imam Khomeini Hospital, 2004- 2005, Tehran, Iran.
Methods: In this cross-sectional study, we evaluated MTB DNA extracted from 3ml citrated peripheral blood samples from 95 adults with new cases of pulmonary and extra-pulmonary tuberculosis. DNA extraction was performed using a commercial PCR kit with IS1081 primers. For prevention of cross contamination and reduction of false positives, all steps were performed under laminar hood.
Results: The 95 patients, 59 of whom were male, had a mean age 44.44 years (SD±20.26) 69 cases had pulmonary and 26 had extra-pulmonary tuberculosis. PCR was positive in 32 (33.7%) patients and negative in 63 (66.3%) cases. The overall sensitivity and accuracy of the PCR assay was 44.1% for pulmonary, 19.2% for extra-pulmonary and 10% for disseminated tuberculosis, respectively.
Conclusion: The low sensitivity of the IS1081 primer MTB-PCR assay on PBMC may pose problems for the rapid diagnosis of tuberculosis. However, further studies are needed to confirm this technique as an alternative test for the diagnosis of tuberculosis.
Yalda A, Seyyed Alinaghi Sa, Hajiabdolbaghi M,
Volume 66, Issue 7 (6 2008)
Abstract
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There are limited published investigations about
adherence to antiretroviral and its determinants. Many determinants influence on
adherence to therapy. The effects of some determinants on adherence are
controversial. More studies are needed to be fulfilled about adherence and its
determinants to compile strategies. Key to the success of antiretroviral
therapies is the ability and willingness of HIV-positive individuals to adhere to antiretroviral
regimens. There are
different definitions for full adherence. In the most studies, adherence is defined as taking ≥95% of prescribed medication.
Adherence rate needs to be >95% to prevent virologic failure and for complete supper-ssion.
The consequences of poor adherence include not only diminished benefits for the
patient, but also the public health threat of the emergence of
multidrug-resistant viruses, as these resistant strains can then be transmitted
from a patient to their contacts. Evaluating adherence has proven to be
difficult and
there is no gold standard for evaluating adherence to medication. Adherence is assessed
in various ways. The most studies evaluate adherence to treatment by
using patient's self report and the pill count
method but these are methods known to overestimate adherence. Some determinants
are associated with adherence include: age, gender, addiction specially
injection drug users, alcohol consumption, depression, social support, level of
education, work situation, adverse antiretroviral effects, pregnancy, type of
antiretroviral drug regimen, number of pills and daily doses received, severe traumas, social and psychological factors,
and relationship between clinician and patient.0
Kashi Ah, Yadyad Mj, Hajiabdolbaghi M, Jafari S,
Volume 66, Issue 9 (5 2008)
Abstract
Background: Behavioral Consultation Centers are the main organizations responsible for providing HIV/AIDS patients with services according to the Iranian Ministry of Health guidelines. In this study we assessed provision of these supposed services to Iranian HIV/AIDS patients referring to Behavioral Consultation Centers.
Methods: One hundred seventy one clinical files were selected by systematic random sampling from the files of all new HIV/AIDS patients accepted at Imam Khomeini behavioral consultation center who were registered during 2005-2006 and were followed for at least six months. Data were extracted from files and included consultation, vaccination, laboratory and treatment services.
Results: Family planning and HIV prevention methods consultation were performed for 32.5% and 2.29% of patients respectively. CD4 count was done for 69% of patients. 65.6% of patients who needed anti-retroviral treatment were given medication. Hepatitis B and Td vaccination were done for 21.7% and 3.5% of patients respectively. Coverage of pneumococal and influenza vaccinations was less than 5%. 79.5% of patients who needs tuberculosis prophylaxis were given medication. TB case finding was 14% during one year and the cure rate for patients under anti TB treatment were 95.8%.
Conclusion: Coverage of consultations and vaccination services are very low. Antiretroviral therapy coverage is intermediate. TB case finding and its cure rate are appropriate.
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.
Farzad Katiraee, Ali Reza Khosravi, Vahid Khalaj, Mahboubeh Hajiabdolbaghi, Ali Asghar Khaksar, Mehrnaz Rasoulinejad, Mir Saeed Yekani Nejad,
Volume 68, Issue 1 (4 2010)
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Background: Oropharyngeal candidiasis is the most frequent fungal
infection in HIV patients. The aims of this study
were to appraise prevalence of oropharyngeal candidiasis and to determine
factors associated with oropharyngeal candidiasis and oral yeast colonization
among Iranian HIV patients.
Methods: The patients were composed 150 Iranian HIV positive individuals referred to Iranian Research Center for HIV & Aids (IRCHA), Imam Khomeini Hospital complex
in Tehran, Iran. Oral samples were obtained and cultured on mycological media. TCD4 lymphocyte count/percentage was
measured and patients were categorized. Patients evaluated for some risk
factors for oropharyngeal candidiasis and oral candida colonization.
Results: Fifty nine percent of patients
were presented with oropharyngeal candidiasis and the carriage rate of yeasts
was 116 (77.2%). The most frequent isolated candida
species were Candida albicans (102) 50.2% and Candida glabrata (45) 22%. Thrush in 57(38%), perleche in 30(20%) and erythematous lesions in 7(4.7%) of patients were observed.
Significant differences in TCD4 count (p=0.01), gender (p=0.02), antifungal therapy (p=0.001), smoking (p=0.02), and intravenous drug use (p=0.03), between asymptomatic and
symptomatic patients were observed.
Conclusion: Oral candidiasis is a frequent complication among Iranian HIV individuals. C. albicans and C. glabrata are most important etiologic agents of oral candidiasis. In Iranian HIV individuals TCD4 count, antifungal
therapy, gender, smoking and intravenous drug use are important risk factors for oropharyngeal
candidiasis. Denture wearing and age are predisposing factors for oral colonization.
Katiraee F, Khosravi Ar, Khalaj V, Hajiabdolbaghi M, Khaksar Aa, Rasoulinejad M,
Volume 70, Issue 2 (4 2012)
Abstract
Background: Oropharyngeal candidiasis and antifungal drug resistance are major problems in HIV positive patients. The increased reports of antifungal resistance and expanding therapeutic options prompted the determination of antifungal susceptibility profile of Candida species isolates in Iranian patients living with HIV/AIDS (PLWHA) in the present study.
Methods: One hundred fifty oral samples from Iranian HIV positive patients were obtained and cultured on CHROMagar and Sabouraud's dextrose agar. All isolates were identified according to assimilation profile, germ tube, colony color and other conventional methods. Disk diffusion testing and Broth Microdilution of six antifungal agents were performed according to the methods described in CLSI.
Results: Candida albicans (50.2%) was the most frequent isolated yeast, followed by C. glabrata (22%). Non-Candida albicans species were isolated from 71 (61%) positive cultures. 25.7% of Candida albicans isolates were resistant to fluconazole (MIC≥64 µg/ml) as were 21.9% and 16.4% to ketoconazole and clotrimazole (MIC>0.125 µg/ml), respectively. Resistance to polyene antifungals including amphotericin B and nystatin, and caspofungin were scarce. 57.7% of candida glabrata isolates were resistant to fluconazole, 31% to ketoconazole and 35% to clotrimazole.
Conclusion: Screening for antifungal resistant candida isolates by disk diffusion or broth dilution methods in clinical laboratories is an ideal surveillance measure in the management of oral thrush in patients with HIV/AIDS. Although nystatin is widely used in clinical practice for HIV positive patients, there was no evidence of enhanced resistance to it. Regarding no resistance to caspofungin, its administration is suggested.
