Showing 7 results for Soudbakhsh
Soudbakhsh A R, Ahmadinejad Z, Sistanizadeh M,
Volume 61, Issue 1 (13 2003)
Abstract
Introduction: In the patients with smear-positive pulmonary tuberculosis (TB) bacteriologic assessment of sputum for detection of acid bacilli (AFB) Has essential role. This evaluation is accomplished by direct sputum smear & sputum culture. These examinations must be done in regular and preferably monthly after beginning of treatment. These tests have two important aims, including, determining of treatment efficacy & duration of isolation.
Methods and Materials: Most of the studies have that classic six month regimen led to sputum smear conversion & negative sputum culture in 85% of patient. This treatment regimen has two phases, including, attack phase and maintenance phase. In the attack phase we use four drugs, including, Isoniazid (INH), Rifampin (RMP), Pyrazinamide (PZA) and Ethambutol (EMB) for the first 2 months and if necessary until the end of third month. In the maintenance phase we use INH and Rif for the remaining of treatment course. The main objectives of this study were to determine the time needed for smear conversion and assessment of probable factors which may influence the smear conversion until 4 months after beginning of therapy. The factors that were assessed, were, Age, nationality, sex, clinical symptoms, underlying diseases, chest radiography (number of cavities), smoking, drug abuse and concentration of AF13 in the sputum Generally, we did this cross sectional study on the patient's records, who had been observed in Imam Khomeni Hospital, west health service center and masih daneshvary hospital between.
Results: This study showed that from totally 218 patients, 138(74.6%) patients had sputum conversion at the first 2 months of treatment and until the end of 3rd & 4th month this rate reached to 83.3% respectively. So in the end of fourth month only 32(14.7%) patients did not show sputum smear conversion. On the other hand this study showed that two factors including presence of cavities in chest radiography & concentration of AFB in the sputum are influencing this rate strongly.
Conclusion: Role of other factors such as age, nationality , Smoking, diabetes mellitus and weigh loss are controversial and another studies are necessary for confirming their roles. Other factors including sex, clinical symptoms has not been show to be important. Some factors such as drug abuse and immunosuppresive therapy has not been assessed in this study, because number of cases were not enough for statistical analysis.
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.
Jafari S, Soltanpour F, Soudbakhsh A, Safavi E, Rokni Yazdi H, Navipour R, Hajizadeh E,
Volume 64, Issue 8 (13 2006)
Abstract
Background: Community-acquired pneumonia could be a life-threatening condition especially in elderly patients. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We compared the clinical and paraclinical profiles in elderly and nonelderly patients with community-acquired pneumonias.
Methods: In this cross-sectional study, seventy nine patients who were hospitalized with community acquired pneumonia over a period of one year were included. Patients' medical records were reviewed and data related to comorbid conditions, signs and symptoms, laboratory and radiographic findings were gathered using a checklist.
Results: The clinical features, laboratory parameters and complications from pneumonia were almost similar in 41 elderly (group I, age ≥65years) and 38 young (group II, age<65years) subjects. Delirium was seen more in elderly group (p=0.05). The average body temperature and pulse rate were significantly higher in nonelderly group. Sixty one percent of elderly patients and 21% of young patients have Po2 less than 60 (p=0.02). Smoking (29.1%), neurological disturbances (19%), congestive heart failure (15.2%), chronic obstructive pulmonary disease and diabetes mellitus (13.9%) were associated comorbidities in both groups. In non elderly group, immune compromise and IV drug use were more common as underlying comorbid conditions. Two of three mortalities were due to elder patients.
Conclusion: Community acquired pneumonia could have more serious clinical and abnormal laboratory features in the elderly than younger patients. Mortality rate may be higher in older patients. Comorbid conditions are frequently seen in both elderly and nonelderly patients with community acquired pneumonia, but IV drug use and immune compromise are more frequent in nonelderly patients.
Hasibi M, Soudbakhsh A., Abadi Z, Mehdipoor P,
Volume 65, Issue 10 (2 2008)
Abstract
Background: Infectious diseases are usually treatable however, infectious disease is one of the most common causes of mortality in hospitals. Furthermore, an apparent functional stagnation around the weekends in hospitals can increase the mortality rate. The goal of this study is to describe the causes and predisposing factors of mortality and to evaluate the role of holidays on patient mortality in infectious disease wards.
Methods: In this retrospective descriptive-analytic study, we examined the files of patients who had expired while hospitalized in the infectious disease ward of Imam Khomeini Hospital from 2002 to 2004. All of the information was gathered from patient files and the mortality committee of Imam Khomeini Hospital. Patient mortality rates were determined for each year. Mortality rates for the various days of the week were estimated and compared for 2004.
Results: The total number of patients included in this study was 3979. Of these, 216 cases had expired, 143 of whom were male (66%). The common causes of mortality were sepsis (26%) bacterial pneumonia (22%) and tuberculosis (19%). The mortality rates were 5.08%, 5.31% and 5.84% in 2002, 2003 and 2004, respectively. In 2004, mortality rates were 9.21%, 10.21% and 4.56% for holidays, pre-holidays and other days of week, respectively. A significantly higher rate of mortality was observed for holidays and pre-holidays compared to the other days of week. (P value <0.05).
Conclusions: Fortunately, the mortality rate of 5.43% in this infectious disease ward was not high. Since sepsis, bacterial pneumonia and tuberculosis were the most common causes of mortality, extra care of patients with these diseases is necessary. As a result of the findings of this study, we recommend increasing expert hospital staff and improving the quality of diagnostic and treatment services during holidays and pre-holidays.
Abdi Liaie Z, Soudbakhsh A, Atarod L, Toogeh Gh, Nakhjavani M, Mousavipanah P, Ashidari B, Amini M, Shakeri F, Hashemi S, Samei Sh,
Volume 65, Issue 12 (2 2008)
Abstract
Background: Myeloperoxidase (MPO), an iron-containing protein, is found in the azurophilic granules of neutrophils (PMNs), and catalyzes the conversion of hydrogen peroxide and chloride ions (Cl) into hypochlorous acid, which plays an important role in oxygen-dependent bacterial killing. The enzyme was first isolated in 1941, and deficiency of MPO was first described in 1954. Fewer than 5% of patients with MPO deficiency contract severe infections, which are usually fungal infections in diabetes mellitus (DM) patients. Besides the disorder in antifungal activity, diminished rate of bacterial (S. aureus) killing, and carcinogenesis, it seems that MPO deficiency is also related to atherosclerosis, degenerative neurologic diseases, as well as other disorders. In this study, we compared the levels of the MPO enzyme in the peripheral neutrophils of infected and non-infected DM patients at Imam Khomeini Hospital during 2005-2006. We compared these two groups the prevalence of MPO deficiency in each group, in order to then determine any correlations this may have with infection.
Methods: In this case-control study, 50 patients were in the infected group (case group) and 50 were in the control group. Patients were chosen using simple sampling methods. Data was gathered from blood samples, using a qualitative test to determine MPO deficiency (Kaplow stain), laboratory results (BUN, Cr, PMN, HbA1c), interviews and completion of a questionnaires, as well as hospital records. Data were analyzed with SPSS software using T test and chi-square test, with a confidence index of 0.05.
Results: In spite of differences seen in stained slides, the MPO enzyme was positive in all of the patients, and no differences were seen between the two groups.
The average patient age and the duration of DM in the case group were more than those of the control group. No statistical differences in the type of DM and glycosylated hemoglobin (HbA1c) levels were found between the two groups. Body mass indexes (BMI) and PMN counts were higher in the case group. The most prevalent infections were in the skin and soft tissue, bones and joints, as well as chronic respiratory infections (TB), pneumonia, urinary infections, CNS infections, gastrointestinal and intra-abdominal infections, mucormycosis, and sepsis.
Conclusions: We found no correlation between MPO enzyme deficiency and age, sex, type or duration of DM, HbA1c levels and BMI.
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.
Zahra Ahmadinejad , Abdolreza Soudbakhsh , Atefeh Tayebi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Sepsis is the leading cause of hospital admission and mortality. One marker for differentiation between infectious and non-infectious diseases is serum procalcitonin (PCT) level. The goal of this study was evaluation of serum procalcitonin level for differentiation among infectious & non infectious systemic inflammatory response syndrome (SIRS).
Methods: In a cross sectional study 263 patients with probable symptoms of sepsis that admitted to emergency department of Imam Khomeini Hospital Complex in Tehran, Iran, between 2006 and 2008, were evaluated for serum procalcitonin level by semi quantitative method. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes.
Results: A total of 263 patients enrolled in the study. Mean age in study patients was 46.9 year (20.7) and most of the patients were male (65.8%). In 104 patients (39.5%) serum procalcitonin level was less than 0.5 (ng/ml), in 49 patients (18.6%) was between 0.5 and 2 (ng/ml), in 74 patients (28.1%) was between 2 and 10 (ng/ml) and in 36 patients (13.8%) was more than 10 (ng/ml). Sixty three patients (60.6%) with PCT<0.5ng/ml, had non-infectious SIRS, while all patients with PCT≥10ng/ml, had infectious SIRS. Procalcitonin level in patients with infectious SIRS was significantly more than patients with non-infectious SIRS (p<0.0001). Sensitivity of test for cut off point of 0.5, 2 and 10 (ng/ml) were 89.2%, 67.1% and 22.8% respectively, and its specificity for cut off points of 0.5, two and 10 were 82.9%, 96.2% and 100% respectively.
Conclusions: Procalcitonin level in combination with an appropriate clinical assessment can help us in beginning of antibiotic therapy timely and improve diagnostic and prognostic evaluation of patients with sepsis.
