فهرست مطالب afsane vaezi

Prophylaxis could be an established strategy to potentially prevent and control infectious diseases and should be considered in the coronavirus disease 2019 (COVID‑19) pandemic. The present study aimed to assess the effectiveness of hydroxychloroquine as a prophylaxis treatment strategy in the reduction of the risk of COVID‑19 among health professionals.

The health professionals were randomly assigned (1:1) to the control group without receiving any hydroxychloroquine as prophylaxis and the hydroxychloroquine group receiving a weekly hydroxychloroquine dose of 400 mg up to 12 weeks.

A total of 146 health professionals were randomly enrolled in this study between August 11 and November 11 in 2020. Among the screened health professionals, 21 (14.6%) were infected with COVID‑19 during the 12 weeks, and 14 (66.6%) out of the 21 health professionals were in the control group. Most participants with COVID‑19 had mild symptoms (62%). In addition, 9.5% (n = 2) of the participants suffered from moderate disease and 28.5% were diagnosed with severe symptoms. In the hydroxychloroquine group, 5 (7.1%) and 2 (2.8%) participants were reported with mild and moderate symptoms of COVID‑19, respectively, and 2 participants had moderate, 8 (10.9%) participants had mild symptoms, and 6 (8.2%) participants had severe symptoms in the control group, within 3 months. Severe symptoms of COVID‑19 were not observed in the hydroxychloroquine group.

This study addressed the effect and benefit of hydroxychloroquine administration for the prevention of COVID‑19 among health professionals. The improved perception of prophylaxis might highlight its important role in future COVID‑19 outbreaks to prevent hospital transmission, which is a major route of spread.

This study aimed to assess the prevalence of human T-lymphotropic virus type 1 (HTLV-1) among brain-dead organ donors at Masih Daneshvari Hospital in Tehran, Iran.

By enzyme-linked immunosorbent assay (ELISA), 54 organ donors were screened for HTLV-1 virus in this descriptive cross-sectional study. Following that, Western blot confirmation was performed to confirm the HTLV-I infection.

Anti-HTLV-1 antibodies were detected in 2 (3.4%) cases out of 54 patients tested by ELISA. A western blot was performed in cases of positive results, but none of the subjects tested positive for HTLV-1 infection.

The results of the present study indicated rare cases of HTLV-I infection in brain-dead organ donors. However, it is recommended that organ donors be investigated for the prevalence of this virus.

The caspase recruitment domain containing protein 9 (CARD9) deficiency is a primary immunodeficiency disorder that affects the innate immune system, resulting in increased susceptibility to fungal infections. We describe progressive disseminated phaeohyphomycosis due to a melanized fungus in a 26-year-old healthy female with inherited CARD9 deficiency to highlight the clinical presentation of this disorder.

The diagnosis of disseminated phaeohyphomycosis due to melanized fungi was made on the basis of clinical and histopathological findings. CARD9 gene was sequenced and a homozygous c.883C>T mutation in exon 6 at codon 295 was found, resulting in a mutation at position 295, Q295X.

There are more cases of fungal infection associated with CARD9 deficiency in Iran compared to other Asian countries. Although consanguineous marriage is common in the Middle East, severe fungal infections related to CARD9 deficiency were only reported from Iran and Turkey. The higher incidence in comparison to other Middle Eastern countries may be associated with rapid population growth, large family size, and the availability of diagnostic facilities. Although Iranian patients with Q295X mutation are susceptible to candidiasis and dermatophytosis, our patient is the first report of phaeohyphomycosis related to Q295 mutation.

The present study aimed to provide an overview of epidemiology, pathogenicity, clinical diagnosis, and treatment of Candida esophagitis in human immunodeficiency virus (HIV)-infected patients. The review process involved studying all the existing literature published on this Candida infection. Esophageal candidiasis (EC) is the most common manifestation of mucosal candidiasis and patients with HIV are predominantly at the risk of this opportunistic infection. The prevalence of EC indicated diverse ranges among HIV patients in different geographic areas due to antiretroviral therapy (ART). The main factors for EC were gastric ulcers, CD4+cell count <200 cells/mL, and HIV viral load >400 cells/mL in the ART era. However, a low CD4+ cell count (<200 cells/mL) was significantly associated with EC in the pre-ART era. The interactions between the Candida virulence factor and host immune defense lead to the host responses against this fungal pathogen. During the Candida albicans invasion, secretion of candidalysin which is encoded by the hyphal gene ECE1 has a potential role in epithelial cell damage and secretion of stimulated cytokine. Early trials of the empirical antifungal therapy are recommended before an endoscopic examination. Esophageal biopsy should be considered in patients with a failure of empiric antifungal treatment as it may allow the possibility of drug-resistant Candida and other opportunistic pathogens. The first-line induction treatment of Candida esophagitis is based on oral fluconazole. The shift from C. albicans to non-albicans Candida (NAC) may be correlated with the development of fluconazole resistance and relapse or therapeutic failure in this infection. An increase in the intrinsic and acquired resistance has raised the significance of the optimal antifungal therapy for the critically ill patient. Candida esophagitis requires a systematic suspicion for early diagnosis and appropriate management of HIV infected patients in order to prevent delayed treatment related to undesirable morbidity or even mortality scores.

Background and Purpose: Denture stomatitis is a chronic inflammation disease of the oral mucosa, which is specified by erythematous lesions mainly in the upper palate. Nystatin as a polyene, a class of antifungal agents, is one of the effective drugs to treat denture stomatitis. Considering the expansion of utilizing herbal drugs to cure many kinds of diseases, the present study was conducted to investigate the effects of Camellia sinensis (green tea), which has the most chemical and influence similarity with nystatin, against denture stomatitis. This study was conducted on 22 patients with a positive mycological evidence for denture stomatitis caused by Candida species. The study population was divided into two groups, namely green tea and nystatin, receiving green tea mouthwash 0.5% and nystatin suspension 100,000 U/ml, respectively. The lesion size and number of yeast colonies were measured before and after the treatment. According to the results, both groups showed reduced lesion size, clinical improvement, and significant reduction of Candida colony count in both group of patients were showedafter the therapeutic. Based on the results of polymerase chain reaction, Candida albicans was the most common species isolated from denture stomatitis. There was no significant difference between the two study groups in terms of Candida species distribution (P=0.700). Green tea demonstrated a comparable anti-Candida activity with regard to nystatin; therefore, it could be recommended as an alternative treatment.

Background and The choice of antifungal agent in treatment of Candida urinary tract infections (CUTI) is dependent on the site of infection, the underlying disease of the patient, and the pharmacokinetics/pharmacodynamics (PK/PD) of the agent. This study aimed to perform a review of antifungal therapy for CUTI.
Data was obtained by a search for full-text articles in Medline, PubMed, Embase, Scopus, Web of Science, Science Direct, Google Scholar, Magiran, Irandoc, and Iran Medex published from 1994 until 2016. The search keywords included urinary tract infections, Candida species, diagnosis, and treatment.
Fluconazole is the drug of choice for prophylaxis and treatment of CUTI due to low toxicity, high solubility, and wide tissue distribution. Although flucytosine is concentrated in urine and has potent activity against Candida species, treatment is restricted because of its toxicity and expansion of resistance when it is used alone. In addition, amphotericin B is an active drug against most Candida species (except resistant C. krusei strains). Other azoles and echinocandins are not effective for treating CUTI due to the minimum excretion of the active compound into the urine. However, a localized renal infection followed by blood spreading might be treated by echinocandins because of its effective tissue concentrations.
We presented diagnostic tests and treatment protocols of CUTI, but new surveillance protocols and diagnostic strategies for control and prevention of CUTI in critically ill patients are essential.

Voriconazole is an antifungal triazole, approved for management of invasive fungal diseases in patients. It is absorbed during two hours and its serum levels will be above 90%, based on the underlying factors, when the drug is administered orally. Voriconazole shows a propotional increase in an area under the plasma concentration-time curve (AUC), with increasing dose. Plasma protein binding of voriconazole is approximately 60%. Standard doses of the drug and optimal concentration are not predictable due to voriconazole’s nonlinear pharmacokinetics, drug-drug interactions, age, and genetic polymorphisms of the cytochrome CYP2C19. Therefore, in order to prevent adverse effects and optimize outcomes, therapeutic drug monitoring is highly suggested. The application of linking pharmacokinetic and pharmacodynamics characteristics provides information about the relationships between antimicrobial in vitro susceptibility, dosage, drug concentrations and antimicrobial or toxicological effects. The current review paper presents a comprehensive overview of the relation between pharmacokinetic and pharmacodynamics parameters for voriconazole treatment efficacy.