Showing 9 results for Rasoolinejad
M Rasoolinejad ,
Volume 57, Issue 4 (9 1999)
Abstract
Brucellosis is a multisystem disease with diverse clinical presentations and involvement of the nervous system is considered to 5 to be 10% in adult patients and 1% in children. The presentations of neurobrucellosis includes meningoencephalitis, subarachnoid haemorrhage, myelitis, radiculoneuritis, intracerebral and epidural abscess, psychosis and vascular syndrome. Twenty-two patients with neurobrucellosis are described. Ten patients had meningoencephalitis, seven patients had meningitis, three patients had polyradiculopathy and one patient presented with spinal epidural abscess and one patient had brain abscess. Results of an agglutination test for Brucella in serum were positive for all patients (>1:160) eight of 15 patients had positive agglutination test in CSF. Five patients had positive blood cultures, 3 patients had positive bone marrow cultures and 2 of 15 patients had positive CSF cultures. All of cultures were Brucella Mellitensis. Antimicrobial treatment included concurrent administration of Doxycycline, Rifampin and Trimethoprim-Sulfametoxazole. Four patients received Dexamethason concurrently. In conclusion, nervous system involvement is a serious manifestation of brucellosis. As brucellosis is an endemic disease in Iran we suggest that brucellosis be investigated with neurological symptoms and signs.
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.
A Hadadi, M. Rasoolinejad, S. Davoudi, M. Nikdel, M. Rasteh ,
Volume 64, Issue 5 (1 2006)
Abstract
Background: Pulmonary TB is still the most common form of the tuberculosis in HIV infected patients with different presentations according to the degree of immunosuppression. The aim of this study was to investigate the impact of HIV infection on the clinical, laboratory and radiological presentation of tuberculosis.
Methods: We compared 80 HIV negative pulmonary TB patients with 40 HIV positive pulmonary TB patients during 1999-2005 in a teaching hospital of Tehran University of Medical Sciences, Iran.
Results: Tuberculosis was more common in men in both groups. The mean age of HIV positive patients was lower than HIV negatives (35.95+/-10.4 versus 46.95+/-20.39, P =0.002). Weight loss and chronic cough were significantly more frequent in HIV negative patients (76.3% vs. 45% p<0.001 and 93.8% vs. 80%, P<0.05 respectively), whereas fatigue were more prominent in HIV positives (45% vs. 21.3%, P< 0.001). Cavitations and infiltrations were reported in the CXR of HIV/TB patients less than HIV negative patients (OR=0.21, 95% CI: 0.05-0.97, P= 0.01 and OR=0.27%, 95% CI: 0.09-0.75%, P =0.02 respectively). Primary involvement pattern was observed more than secondary involvement in HIV/TB group (OR=3.95, 95% CI: 1.73-9.03, P =0.001). The laboratory findings in HIV/TB patients were as follows: more negative PPD skin (75% vs. 50%) tests, higher ESR (86.5% vs. 63.7%), lower mean Hb (10.6 vs. 12.4) and lower mean leukocyte (6545 vs. 9195) and lymphocyte count (1281 vs. 1838). In all of the above mentioned findings the differences between two groups were significant. Fourthy Seven% of patients had Lymphocyte count less than 1200 which means they were in AIDS stage.
Conclusion: Immune system suppression in HIV can alter the clinical, laboratory and radiological features of tuberculosis. It is crucial to consider tuberculosis in differential diagnosis of every HIV patients with respiratory symptoms.
Haji Abdolbaghi M, Makarem J, Rasoolinejad M, Afahami Sh, Fazeli Ms, Unesian M, Adili F, Alavi S. Sh,
Volume 64, Issue 8 (13 2006)
Abstract
Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods.
Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance.
Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended.
Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.
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.
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.
Jafari S, Rasoolinejad M, Emadi Kouchak H, Mokarami F,
Volume 67, Issue 7 (7 2009)
Abstract
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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.
Mehrnaz Rasoolinejad , Azar Hadadi , Mojtaba Hedayat Yaghoobi , Banafshe Moradmand Badie , Neda Alijani ,
Volume 71, Issue 7 (October 2013)
Abstract
Background: HIV infection reduces the immune system and is the most significant factor in the spread of TB in recent years and one of the causes of death in HIV -seropositive patients. TB is the most commonly diagnosed opportunistic infection and the most frequent direct cause of death among HIV infected patients. The HIV infection can accelerate progression of TB infection to active TB disease. Among patients with active TB, those with HIV co-infection have the greatest risk for relapse. Regardless of increasing rate of TB and HIV in Iran, we decided to s urvey outcome of TB in HIV positive patients who treated with standard regimens in the years 2003-2012.
Methods: This retrospective cohort study was conducted on HIV-positive patients with TB referred to Behavioral Diseases Consultation Center and Infectious Diseases Ward of Imam Khomeini Hospital from 2003 to 2012. Outcome was defined as failure, relapse and mortality. Moreover, the relationship between outcomes and number of CD4, co-trimoxazole and antiretroviral intake, type of TB and AIDS defining illness was studied. Results: This study had 135 patients, 8 (5.9%) were females and 127 (94.1%) were males. The mean age of the patients was 40.14+10.02 and the most way to catch HIV in this study was intravenous drug user. There were 3 (2.22%) cases of failure, 15 ( 11.1%) relapse , and 21 ( 15.8%) deaths. Antiretroviral therapy, AIDS defining illness, type of TB and co-trimoxazole intake did not soley affect relapse. CD4 level was the most effective variables in relapse [ Hazard ratio: 0.392 (0.11-1.4) Relative Risk: 0.809 (0.593-1.103) (P=0.068) ]. However, regard to CI95%, the impact of CD4 on relapse is not significant and antiretroviral intake was the most important and effective variable in increasing their survival. Hazard ratio: 0.137 (0.141-0.45) Relative Risk: 0.686 (0.513-0.918) (P=0.001) Conclusion: Overall, receiving antiretroviral was the most important factor influencing the outcome of patients. |
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.
