Diagnosed tuberculous meningitis using cerebrospinal fluid polymerase chain reaction in patients hospitalized with the diagnosis of meningitis in referral hospitals in Isfahan.

BACKGROUND: Tuberculosis (TB) remains one of the leading infectious diseases throughout the world. Among various forms of extrapulmonary TB, tuberculous meningitis (TBM) is the most severe form and remains a major global health problem with a high mortality rate. Our study was designed to evaluate tuberculous polymerase chain reaction (PCR) positive rate in patients who present with fairly long symptoms of meningitis. MATERIALS AND METHODS: The 162 Patients with an indolent onset of symptoms compatible with central nervous system infection were admitted. Sample of cerebrospinal fluid (CSF) was evaluated for biochemistry and tuberculous real-time PCR. Data analyzed by Student's t-test and Fisher's test. RESULTS: Patients were mostly male (69.8%), with a median age of 43.69 ± 22.67 years. CSF real-time PCR results in 6 patients (3.7%) were positive for tuberculous DNA. Of these 6 patients, 4 of whom were men and two of whom were women. In other words, the frequency of positive tuberculous DNA was in male 5.3% and female 1.4%, respectively. CONCLUSION: Given that we live in Iran and in the vicinity of the tuberculous endemic countries, if we face a meningitis case with lasting symptoms and tendency to be chronic, TBM should be considered.

Prevalence and clinical characteristics of headache among medical students, Isfahan, Iran.

BACKGROUND: Headache is one of the most common complaints during medical curriculum and it occurs due to numerous psychological and physical stressors, which are more common in medical students than general population. The purpose of this study was to evaluate the frequency of different types of headache and associated factors. MATERIALS AND METHODS: This cross-sectional study was conducted in Isfahan University of Medical Sciences, from September 2011 to January 2012. First- to seven-year medical students who have experienced some forms of headache in their life and had headache attacks during the past 6 months were included in this study. All medical students completed a structured check list, which consisted of demographics data, associated factors, and headache characteristics. RESULTS: A total of 480 (258 [53.8%] males and 222 [46.2%] females) students (93.7%) were evaluated. The prevalence of headache was 58.7%, the prevalence of migraine, and tension-type headache was 14.2% (10.5% in male vs. 18.5% in female, P = 0.08) and 44.2% (49.2% in male vs. 39.2% in female, P = 0.006), respectively. A family positive history was found in 9.5% of students with headache. The lower socio-economic status, year of study (3(rd) and 5(th) year students), was seemed to had higher prevalence in students with headache. There was no significant difference between headache and concomitant disease. CONCLUSION: The results demonstrate that prevalence of headache is high among medical student. Socio-economic and the year of study might be significant factors in the prevalence of headache. Further multicenter studies would be necessary to evaluate headache epidemiology among medical students in the whole country.

The correlation between early complications of percutaneous coronary intervention and high sensitive C-reactive protein.

BACKGROUND: Increased incidence of cardiovascular diseases, especially coronary artery disease (CAD), during recent decades shows this disease entity to be the leading cause of death in the world. On the other hand many successes were achieved in the treatment of these diseases with new technology, which has its own side effects and threats for the patient. Among these new strategies is percutaneous coronary intervention (PCI), especially with stent implantation. Although coronary stents are effective in the treatment of dissection and prevention of restenosis, many side effects and even death have been observed, from 5-10% per year. Some studies showed that there is a relation between high sensitivity C-reactive protein (hs-CRP), as a laboratory marker for early detection of thrombosis and/or restenosis, and early complications of percutaneous coronary intervention. The aim of this study is to evaluate hs-CRP level in patients after PCI and to investigate if this can be a prognostic value for detection of early complication. METHODS: This is a descriptive, analytical study done in Shahid Chamran Hospital (Isfahan, Iran) in 2011-2012. 87 patients who had undergone PCI were studied. Their hs-CRP level was measured before and after the study. Moreover, early stent complications were detected during the first 24 hours after insertion. The data was recorded in a researcher-constructed checklist and analyzed by SPSS for Windows 20. RESULTS: The mean ± SD of hs-CRP level in patients with and without complication were 1.36 ± 0.97 and 3.09 ± 1.8, respectively. According to Student's t-test, the hs-CRP level in patients with early complications was higher than patients without early complications of stent implantation; the difference was statistically significant (P < 0.001). CONCLUSION: The hs-CRP serum concentrations of patients with, and without early stent complications were significantly different. According to the control diseases center (CDC) guideline, patients with a high level of hs-CRP need special care and attention.