Comparison of three doses of amikacin on alternate days with a daily dose of meropenem during the same period for the treatment of urinary tract infection with E. coli: a double-blind clinical trial.

OBJECTIVES: Urinary tract infections (UTIs) are very common infections in humans, and Escherichia coli (E. coli) is the commonest pathogen leading to UTIs. The generation of beta-lactamase enzymes in this bacterium results in its resistance against many antibiotics. This study compares three doses of amikacin on alternate days with a daily dose of meropenem in the same period for the treatment of UTIs with E. coli in a double-blind clinical trial. METHODS: The current double-blind clinical trial compares three doses of amikacin on alternate days with a daily dose of meropenem in the same period for the treatment of UTIs with E. coli. The patients were assigned to two groups: Intervention (receiving a single dose of amikacin once a day at 48-h intervals for a week, three doses) and control (receiving meropenem for 1/TDS for a week). RESULTS: The E. coli infection frequency was 61 (21 cases of non-ESBL and 40 cases of ESBL-positive infections) and the frequency of the other infections was 52 (46%). In the patients with ESBL E. coli infection, ciprofloxacin (21; 70%) showed the highest antibiotic resistance, and nitrofurantoin (33; 91.7%) showed the highest sensitivity. The baseline variables between the control and intervention groups indicated no significant difference (p > 0.05). The frequency of signs and symptoms showed no significant difference between the amikacin and meropenem groups in the first 24 h and the first week. In the second week of follow-up, no clinical signs or symptoms were observed in the two groups. CONCLUSION: The results of this study showed that treatment with amikacin, 1 g q48h, for one week (three doses) has the same result as meropenem, 1 g q8h, for one week (21 doses). The results are the same for the treatment of UTIs with ESBL positive and ESBL negative. Amikacin can be used once every 48 h to treat UTIs, is less expensive and can be administered on an outpatient basis. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20170417033483N2 on the date 2018-02-13.

Relationship between vitamin D levels and brucellosis: a case-control study from Sanandaj, Iran.

BACKGROUND AND OBJECTIVES: Brucellosis is a zoonotic disease that is caused by the Brucella species. This disease is common in Iran and its incidence is increasing .This study measures serum vitamin D levels in patients with brucellosis and healthy people. MATERIALS AND METHODS: This research was conducted as a case-control study at Tohid Hospital, Sanandaj, Iran. The calculated sample size included 90 patients in the case group and 90 patients in the control group. The measurement of vitamin D levels in the case and control groups were performed by ELISA. RESULTS: The mean serum vitamin D level was 19.91 ng/ml in the case group and 22.87 ng/ml in the control group. (Serum vitamin D level <10 ng/mL is accepted as deficiency, 10-30 ng/mL as insufficiency, 30-100 ng/mL as sufficiency, and >100 ng/mL as toxicity). CONCLUSION: There was no significant difference between the two groups in terms of vitamin D deficiency (p-value=0.097).

Geographical distribution of Anthrax using Geographic Information System (GIS) during 2010-2015 in Iran.

Background: Anthrax is a zoonotic infectious disease that is still considered as a health problem in developing countries. Therefore, the aim of this study was to investigate the incidence and geographical distribution of anthrax using the Geographic Information System (GIS) and predict its incidence in Iran in 2021. Methods: This study is descriptive analytical study. Information on anthrax was obtained from the Center for Communicable Diseases Control during 2010-2015. In the next step, ArcGIS 9.3 was used to prepare geographic maps of the disease incidence and frequency. Therefore, using the Raster Calculator tool, the disease prediction map was drawn. Results: The highest incidence of anthrax during 2010-2015 was observed in the provinces of Kurdistan, North Khorasan, and Chaharmahal and Bakhtiari, respectively. The trend of the incidence of anthrax in Iran had increased from 2010 to 2013, while its incidence decreased in 2014. Based on the results of modeling in Iran, the provinces of Kurdistan, West Azarbaijan, Tehran, and Zanjan, respectively, with 37.16%, 33.83%, 16.78%, and 10.49% of their area (km2) had the highest risk of anthrax disease in the country in the year 2021. Conclusion: Since the provinces of Kurdistan, West Azerbaijan, Tehran, and Zanjan are among the high-risk areas in the country in the coming years, the cooperation between the veterinary organization and the health care system and the vaccination of livestock in these areas can significantly help to control and prevent the disease.

Relation between serum zinc levels and recurrent urinary tract infections in female patients: A case-control study.

Background: Zinc deficiency can increase the risk of infectious diseases. Given that recurrent urinary tract infection is a common complication, this study examines the association between serum zinc levels and recurrent urinary tract infections. Methods: In this case-control study, serum zinc levels for 48 patients with recurrent urinary tract infections were compared with the serum zinc levels of the same number of people in the control group who were matched in terms of location and age. Using SPSS ver. 18, univariate analysis was performed through t-test, correlation coefficient; and multivariate analysis was carried out through multiple regression tests. Significant level was considered as less than 0.05. Results: There was a weak correlation between age and serum zinc level (r=-0.205, p=0.045). Mean serum zinc level of the test group and the control group were 96.83 (±11.25) and 76.72 (±17.06) microgram/deciliter (p=0.001), respectively. Level of zinc reduced with aging; in addition, the group with recurrent UTIs had lower zinc levels than the control group (p=0.010, R2=0.377). Conclusion: According to the results of this study, serum zinc levels of people with recurrent urinary tract infections were lower than that in the control group. It seems that zinc levels are a risk factor for recurrent urinary tract infections.

Does Helicobacter pylori Infection Play a Role in Susceptibility to Brucellosis?

Brucellosis is endemic in Iran. Several studies have shown that brucellosis is associated with other infectious diseases. This study aimed to determine the relationship between Helicobacter pylori (HP) and brucellosis. In this case-control study, 100 patients with brucellosis as cases and 200 participants without brucellosis as controls were evaluated. To compare the prevalence of HP in the 2 groups, odds ratios and confidence intervals for every variable were analyzed using logistic regression models after adjustment for confounding factors. The results obtained in patients with brucellosis showed that fever, sweating, and joint pain were the most prevalent clinical symptoms. In addition, compared with the control group, there was a significant relationship between the IgM antibody to HP and brucellosis infection (estimated odds ratio 2.74; 95% CI: 1.5-4.9) (p = 0.001). Acute infection with HP was associated with brucellosis and increased the risk of brucellosis infection.

ABO blood groups and susceptibility to brucellosis.

The relationship between blood groups and some infections such as norovirus, cholera, and malaria has been reported. Despite the importance of brucellosis, there is a lack of data on the relationship between blood groups and brucellosis. Thus, in this study, we examined the relationship between blood groups and brucellosis. In this case-control study, the blood groups of 100 patients with brucellosis and 200 healthy individuals were studied. Exclusion criteria for the control group consisted of a positive Coombs Wright test or a history of brucellosis. The chi-square test was used to compare qualitative variables between the two groups. The variables that met inclusion criteria for the regression model were entered into the logistic regression model. A total of 43% patients were female and 57% male; 27% were urban and 73% rural. Regression analysis showed that the likelihood of brucellosis infection was 6.26 times more in people with blood group AB than in those with blood group O (P<0.001). However, Rh type was not associated with brucellosis infection. Thus, there is a relationship between blood group and brucellosis. People with blood group AB were susceptible to brucellosis, but no difference was observed for brucellosis infection in terms of blood Rh type.

Tuberculosis peritonitis with features of acute abdomen in HIV infection.

This case report introduces a 26-year-old male IV drug abuser with fever, abdominal pain and distension referred to the emergency ward. According to these findings, abdominal tenderness and involuntary guarding, an explorative laparotomy was performed. Multiple biopsies of omentum, peritoneum and liver were taken. Pathologic assessment of multiple biopsies confirmed intra-abdominal TB infection.

Acute human cytomegalovirus infection with bleeding in iran.

In December 2011, a 42-year-old male farmer was admitted to a hospital in Sanandaj (Western Iran) with fever and anemia in order to check whether he suffered from some infectious diseases. During the first 3 days after admission, the patient gradually developed progressive oliguria, fever, abdominal pain in the right upper quadrant, leukocytosis with toxic granulation, petechiae and ecchymosis, oral bleeding, and vomiting. The sonographic findings revealed splenomegaly and an increase in the thickness of the gall bladder wall. In order to manage the patient and taking into consideration the most probable differential diagnoses, diagnostic tests were performed on two blood samples collected from him, and real-time polymerase chain reaction for human cytomegalovirus was positive.

Diagnostic value of serum adenosine deaminase level in pulmonary tuberculosis.

BACKGROUND: In some studies, the level of adenosine deaminase (ADA) in sputum and effusion liquids was used for the diagnosis of tuberculosis (TB). But it is not always possible to access these materials. The goal of this study is to assess the diagnostic value of serum ADA levels in pulmonary TB patients. MATERIALS AND METHODS: In this study, 40 sputum smear-positive TB patients who were hospitalized and 40 non-TB patients who referred for surgeries were selected. A serum sample was collected and serum ADA level was measured by ADA kit. RESULTS: The average (SD) of serum ADA in TB and non-TB patients were 20.88 (±5.97) and 10.69 (±2.98) U/L, respectively (P value < 0.05). The best cut-off point was 14 U/L. The calculated area under the receiver operating characteristic (ROC) curve was 0.955 (95% CI, 0.914-0.995); sensitivity was 92.7% (95% CI, 84.7-100) and specificity was 88.1% (95% CI, 78.3-97.8) (P < 0.001). CONCLUSION: Serum ADA level may be proposed as a proper index for TB diagnosis.