فهرست مطالب farnoush mirzadeh

Infection with human immunodeficiency virus (HIV) causes progressive dysfunction of cell-mediated immune system. HIV-related immunosuppression significantly increases the risk for acquiring opportunistic infections due to bacteria, viruses, fungi, parasites, and protozoa. These opportunistic infections are a major source of morbidity and mortality in HIV-infected patients. These infections have different clinical manifestations in terms of etiological factors and infected organ. Awareness of these infections and infected organs can help physicians for early diagnosis and appropriate therapeutic intervention. In a cross-sectional study during 2006-2010, all HIV infected patients who had been admitted to Alzahra Hospital (Isfahan, Iran) with the diagnosis of infection were studied. Demographic information, etiology of infection, kind of infected organ, and CD4+ (cluster of differentiation 4) count were surveyed and analyzed by statistical tests. The etiology of infection among the 64 studied patients was bacterial (68.8%), viral (15.6%), protozoal (10.9%), and fungal (4.7%). The most and least commonly infected organs were respiratory system (28.1%) and gastrointestinal system (1.6%), respectively. The mean CD4+ counts in bacterial, viral, fungal, and protozoal infections were 190.5, 170.9, 203.7, and 158.1, respectively. The most common etiology of infection was bacterial infections and the most common infected organ was respiratory system. The mean CD4+ count was 185. According to the analysis of variance, the mean CD4+ counts did not significantly differ based on the infected organ or the type of infection.

The outcome of community-acquired pneumonia (CAP) ranges from full recovery to severe complications and death. Several scoring systems have been developed to determine the severity and prognosis of CAP. Among these, pneumonia severity index (PSI) has become the standard reference because of the prognostic accuracy, effectiveness, and safety as a decision making aid. We conducted a descriptive, prospective study on all patients with CAP who were admitted to the infectious diseases ward of Alzahra Hospital (Isfahan, Iran) during 15 months. We assessed our patients based on PSI scoring system and classified them into 5 risk classes. The mean PSI score in this study was 91.4 ± 33.3 (range: 19-166). According to the calculated scores for each patient, 9 patients (19.1%) belonged to class I, 7 (14.9%) to class II, 7 (14.9%) to class III, 17 (36.2%) to class IV, and 7 (14.9%) to class V. About half of patients admitted to the infectious diseases ward were fine enough to be managed as outpatients. On the other hand, 20% of the patients in class V needed intensive care. It seems that physicians in emergency departments should pay more attention to PSI scoring system to determine the kind and site of care. This scoring system can also be used to assess the prognosis of death.

The second most common vaginal infection is candida vaginitis. The use of anti-fungal traditional medicine and herbal therapies has been increased in recent years. The anti-fungal effect of E.platyloba DC extract on candida has been shown in the in vitro studies. The purpose of this study was to investigate this effect in women with candida vaginitis by in vivo study. A randomized double blind clinical trial was done on 60 married women with candida albicans vaginitis referred to Obstetrics and Gynecology clinic. Patients were randomly divided into two groups. The first group received Echino cream plus fluconazole and the second group received fluconazole alone. Patients were evaluated by the second questionnaire and laboratory studies on vaginal specimens two weeks and 6 months later for recurrence. 14 days after treatment the positive culture of vaginal discharge were observed in 13 cases of (43.3%) the group treated with fluconazole, and 6 cases (20%) treated with fluconazole and Echino cream (p < 0.5). The rate of recurrent candida vaginitis was 17 cases (56.7%) in the group treated with fluconazole, and 8 cases (26.7%) in the second group (p < 0.5). E. platyloba DC extract was effective in women with candida vaginitis. More multicentral studies are needed to evaluate the effects in more details.