farhang baba mahmoudi

Brucellosis is a common disease between humans and animals that still exists in most parts of Iran. This study investigated the epidemiology of brucellosis in Mazandaran province, Iran, during a nine-year period from the beginning of 2009 until the end of 2017.

This descriptive-analytical study was conducted based on the guidelines of Iran’s Ministry of Health and Medical Education on the data of 3732 brucellosis patients. The data were retrieved from the private and public laboratories gathered in a Ministry’s database. We used the generalized estimating equation (GEE) for the Poisson regression model (Poisson GEE) to examine the disease incidence based on the studied variables.

The age-standardized incidence rate has been 13.2 per 100,000 people (15.6 in men and 21.3 in rural areas). The highest rate (17.2) was in 2012 and the lowest (10.6) was in 2014. The cities of Galugah (35.0) and Qaemshahr and Fereydunkenar (3.0) had the highest and lowest incidence rates. The patients’ professions had been 30% housewives, 14.9% ranchers, and 14.4% livestock-related professions. The highest standard incidence was in people older than 55 years old. The results of the Poisson GEE regression model showed that the disease incidence has been higher in men compared to women and in rural compared to urban areas (risk ratio = 1.5, 3.4, P = 0.001).

Mazandaran faces the risk of increased brucellosis incidence rate. Taking preventive measures, including educating people, are recommended for the near future.

The problem issue of coronaviruses is one of the most serious problems in the world. The present study aimed to investigate and describe the clinical characteristics, risk factors of fatality rate, and length of hospital stay in patients with COVID-19 in Mazandaran province.
In this epidemiological study, data from COVID-19 patients admitted to hospitals in Mazandaran province from July 22 to August 21, 2020, were reported. Multivariate logistic regression methods and the Cox proportional hazards model were used to determine the risk factors of fatality.
Out of the 6759 hospitalized patients, 3111(46.03%) patients had comorbidity; 19.77% of them had diabetes, 19.97% had hypertension, and 15.28% had heart failure. Cox regression model on COVID-19 patient data showed that risk factors for fatality including having age over 60 years (HR: 1.93; P< 0.001), intubation (HR: 4.22; P<0.001), SpO2≤ 93% (HR: 2.57; P=0.006), comorbidities of cancer (HR: 1.87; P=0.006), chronic blood diseases (HR: 1.83; P=0.049), heart failure (HR: 1.63; P<0.001), and chronic kidney disease (HR: 1.98; P<0.001).
Paying much attention to risk factors for fatality can help identify patients with a poor prognosis in the early stages. More assessments should also be performed to examine the underlying mechanisms of these risk factors. Highlighting death-related risk factors is crucial to increase preparedness through appropriate medical care and prevention regulations.

Physicians are more presumptuous than patients in verbal interaction. This study was conducted to measure the ratio of physicians’ and patients’ presumptuousness، and the role of gender in order to find an appropriate model for doctor-patient interaction. One hundred and one interviews in Mazandaran Medical Sciences hospitals were studied by using Stiles coding system. The physicians were 10. 4 times more presumptuous than the patients. The most presumptuousness in the physicians was in physical examination، and in the patients، it was in conclusion. The least presumptuousness in physicians and in patients was in history taking and in physical examination، respectively. There was a meaningful difference in presumptuousness between men and women in the patients (P<0. 05)، while there was no meaningful difference between men and women in the physicians. Among the patients، rustics، low educated ones، and the elders were more presumptuous. When the gender of physicians and patients was different، the presumptuousness increased; however، the presumptuousness decreased when the gender was the same. We can conclude that the physicians were much more presumptuous than the patients. Their presumptuousness varied from the most in physical examination to the least in the history taking، because the physicians received information during the history taking and they listened more. In physical examination، the patients were in a special situation، sometimes unrobed. It strongly affected the presumptuousness. Presumptuousness had a direct relation with social class. Social class was the main factor when there was a gender difference، and it increased the physicians’ presumptuousness. The Results showed that in the patients، politeness in lower class decreased the presumptuousness. Knowing these factors can help physicians and patients to have an appropriate outcome.

Depression is a possible side effect associated with antiviral therapy for chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The objective of this study was to evaluate the prevalence of depression in patients receiving different anti-viral medications before، during and after treatment. This descriptive cross-sectional study was undertaken on 248 CHB or CHC patients referred to two clinics of Mazandaran University of Medical Sciences between March 2011 and April 2012. Those who received alpha interferon، another antivirus medication or combination of them were evaluated by Hospital Anxiety and Depression Scale (HADS) and clinical psychiatric interview before initiation of the medications، 12 and 24 weeks after the initiation of the treatment and 6 weeks after termination of antiviral therapy. The prevalence of depression in patients with either hepatitis B or C was higher than general population، but similar to each other. During the 12 and 24 week of the antiviral therapy، the prevalence of depression was increased especially in whom were receiving alpha-interferon. Six weeks after the termination of medical therapy، the prevalence of depression in whom received alpha interferon was decreased statistically. However، this event did not happen in the group that did not use interferon. It is suggested that patients receiving alpha-interferon should be psychologically assessed in the course of treatment. Displaying the symptoms of depression، doctors should apply the prophylactic and therapeutic measures as soon as possible.

Anaplasmosis is an important issue for animal breeders in terms of economic losses as well as a health concern to human. Ticks are considered as the main vector of this disease. Lack of documented information about Anaplasma species in Iran was the scope of this study to determine the population of ticks and the presence of Anaplasma in ticks, domestic ruminants and also human beings in northern Iran. A total of 101 unengorged hard ticks, 78 domestic ruminants and 40 human blood samples collected from Ghaemshahr, Mazandaran Province, northern Iran were tested by nested PCR against 16s rRNA gene of Anaplasma species. Positive PCR was found in 50 ticks, 28 sheep, 2 cattle, one goat, and 10 human specimens. Sequence analy­sis of the PCR products confirmed presence of A. ovis in two Rhipicephalus sanguineus and two Ixodes ricinus ticks, one human and 4 sheep samples. Moreover one Boophilus annulatus tick and one sheep sample were infected with A. bovis. Furthermore one sample of sheep was infected with A. centrale. This study is the first report of tick infection to A. ovis, A. bovis and human infection to A. ovis in Iran. The result of this study is a survey of Anaplasma infections from ticks, domestic animals and human in Iran which help to have appropriate prevention measures for anaplasmosis.

Cefepime was used as empirical treatment in ventilator-associated pneumonia (VAP) induced by gram-negative and gram-positive bacteria. This study aimed to determine the antimicrobial susceptibility pattern of cefepime against microorganism causing VAP in Mazandaran, North of Iran. This study was performed on VAP patients diagnosed with clinical pulmonary infection score (CPIS) scores in ICU of two hospitals. For each patient suspected of having VAP, quantitative culture of endotracheal aspiration (QEA) was performed and MIC was determined by micro dilution test. Data were collected and analyzed. Thirty- five cases of enterobacteriaceae were isolated orderly including E coli 13, P. aeruginosa 11, Enterobacter 7 and K. pneumonia 4 cases. All the isolated E. coli, Enterobacter and Klebsiella, 54.5% of P. aeruginosa isolated were fully resistant to cefepime. The results of this study show that cefepime is not a reasonable choice for empirical treatment of nosocomial pneumonia and VAP.

Background and More than 3% of the world population are infected with Hepatitis Ç virus (HÇV) and 50-80% of these patients progress to chronic disease. Âpproximately 50% of chronically infected patients do not respond to treatment. The purpose of this study was to determine the risk factors for hepatitis Ç virus among high-risk populations (Ïntravenous drug addicts and patients with Thalassemia، Hemophilia، hemodialysis patients) in Mazandaran. Totally، 132 patients (34 with Thalassemia، 31 with hemodialysis، 30 with Hemophilia، and 37 with Ïntravenous drug addiction) were studied. Âll patients had anti-HÇV and were HÇV-RNÂ positive. Demographic data، epidemiological characteristics، clinical findings and laboratory parameters were recorded in questionnaire. Descriptive analysis was used to determine frequency، mean and standard deviation of parameters. Qualitative and quantitative variables were compared by Çhi-square test and ÂNÔVÂ respectively. 132 patients with established chronic infection (mean age، 35. 13 ±11. 92) were studied. The major participants were males (68. 9% against 31. 4%، P=0. 001). The frequencies of alchohol consumtion، drug abuse، history of imprisonment and uncontrolled sex were significantly higher in intravenous drug addicts compered to patients with thalassemia، hemophilia، and patients under hemodialysis (p<0. 0001). However، no significant differences were observed between the prevalences of coinfection with HÏV and/or HBV and also hospitalization history in high risk groups (p=0. 43 and p=0. 48، respectively) Çonclusion: Due to the lack of vaccine for prevention، inadequate medical treatment for HÇV infection and according to the role of nosocomial transmission of HÇV infection، serious prevention efforts should be performed in society specially health-care centers and blood banks. Since intravenous drug addiction may play an important role in HÇV transmission and persistence، it is necessary to perform psychologic and clinical conseling related to importance of risk factors. Âlso، development of health insurance especially for vulnerable groups in society is recommended.