فهرست مطالب peyman eini

Pyogenic brain abscess is a severe neurological infection associated with significant morbidity and mortality. Despite advances in diagnostic techniques, neurosurgical procedures, and antimicrobial therapy, managing pyogenic brain abscesses remains challenging. This article reviews the current understanding of the epidemiology, pathogenesis, diagnosis, and treatment of pyogenic brain abscesses, highlighting the importance of a multidisciplinary approach to improve patient outcomes.

A comprehensive literature review was conducted using PubMed, Scopus, and Google Scholar databases. The search terms included "pyogenic brain abscess," "epidemiology," "pathogenesis," "diagnosis," "treatment," "antibiotic therapy," and "prognosis." Relevant articles published in English between 2010 and 2023 were selected, focusing on the most recent advances and evidence-based recommendations for managing pyogenic brain abscesses.

Pyogenic brain abscess is a life-threatening condition that requires prompt diagnosis and treatment. A multidisciplinary approach involving neurosurgeons, infectious disease specialists, and radiologists is necessary to manage pyogenic brain abscesses successfully.

Early recognition, appropriate antibiotic therapy, and timely neurosurgical intervention are essential for improving patient outcomes and minimizing neurological sequelae. Antibiotic therapy and surgical approach should be tailored to the individual patient, considering factors such as the suspected pathogens, immune status, and the primary source of infection. Long-term follow-up is crucial, as recurrence and neurological sequelae are common among survivors. Continued research is needed to improve our understanding of this complex condition and develop more effective treatment strategies.

Anti-CCP and rheumatoid factor are among the markers that can be positive in brucellosis patients and even have different levels in the patients with and without osteoarticular symptoms. This study was designed and implemented with the aim of comparison of anti-cyclic citrullinated peptide antibody and rheumatoid factor levels in brucellosis patients with and without osteoarticular symptoms.

In this analytical-descriptive study, 106 brucellosis patients were examined. Anti-CCP antibody and RF levels were measured in patients with and without osteoarticular problems using ELISA method. The results were analyzed using SPSS version 16 software. P<0.05 was considered statistically significant.

Among 106 patients, 68 (64.2%) were male and 38 (35.8%) were female. The mean age of the participants in the study was 33.5 years, with the age range of 20 to 55 years. 69 people (65.1%) had bone-joint symptoms, of which 72.5% had arthralgia and 19 (27.5%) had arthritis. About 60% of the patients with osteoarticular symptoms had spondylitis and the least involvement was observed in shoulder. Mean anti-CCP level in the patients with and without osteoarticular symptoms was 7.9 ± 4.9 and 5.4 ± 2.93 U/ml, respectively (P = 0.02). Although the mean rheumatoid factor and ESR levels in the patients with osteoarticular symptoms was higher than those without these problems, but the difference was not significant.

According to the results of the present study, the level of anti-CCP in brucellosis patients with involvement of the skeletal-motor system is higher than the patients without involvement of this system, which may be misdiagnosed with rheumatological diseases.

Selenium (Se) is one of the elements of the body whose deficiency causes immune system weakness. Given that a weak immune system is one of the main causes of sepsis, in this study, it was decided to increase the serum Se level in sepsis patients in hospitals affiliated to Tabriz University of Medical Sciences.

In this cross-sectional descriptive study, 82 patients with sepsis (common, severe, and septic shock) were selected using a two-year census sampling ending on March 21, 2019 from Sina and Imam Reza hospitals in Tabriz. Data related to the etiology of the disease, underlying diseases, comorbidities, and inpatient testing were collected for each patient, and serum Se levels were assessed by atomic absorption spectroscopy. To analyze the data, chi-square, t test, and Mann-Whitney U tests were run using SPSS, version 20, and a P value less than 0.05 was considered statistically significant.

The results of a review revealed that the history of underlying diseases [diabetes (P = 0.009), hypertension (P=0.019), and malignancies (P = 0.029)], comorbidities [pneumonia (P = 0.001), malignancy and chemotherapy (P = 0.012), and meningitis (P = 0.009)], and disease etiology [bacteremia of uncertain origin (P = 0.001), pneumonia (P = 0.001), urinary tract infection (P = 0.009), and skin infection (P = 0.005)] was significantly higher in patients with septic shock compared to those with sepsis and severe sepsis. On the other hand, the severity of the disease was significantly associated with a decrease in the serum Se level (P = 0.010).

In general, serum Se levels decrease with the increased severity of sepsis. Thus, measuring Se levels may be helpful in rejecting the progression of the disease.

Occurrence of pleural effusion occurs in both hospitalized and outpatients. Recognizing the most important and common causes of pleural effusion in each region and in different communities can be a useful step in early and timely diagnosis of the causes and, consequently, timely treatment and thus reducing the time and burden of diagnostic and therapeutic costs imposed on patients.

In this descriptive cross-sectional study, 407 patients admitted to Sina and Shahid Beheshti hospitals in Hamadan were studied by census. Data were analyzed with SPSS software (ver. 16).

From 407 patients with pleural effusion in this study, 262 persons (64.4%) were men and 145 (35.6%) women. There were 244 persons (60%) with exudative pleural effusion, 110 persons (27%) with transudate effusion and 53 persons (13%) with empyema. Out of 244 exudative effusion cases, in 135 cases (55.3%) were recorded pneumonia, 50 cases (20.5%) lung malignancy, 33 cases (13.5%) other malignancies, 13 cases (5.3%) tuberculosis, 7 cases (2.9%) pulmonary thromboemboli and 6 remained cases  (2.5%) were other causes. Pneumonia was the most common cause of empyema.

According to results of this study, exudative pleural effusion was the most common type of effusions. In all types of pleural effusions, the most common site of involvement was right hemithorax. Identifying common causes of pleural effusions in each region facilitates the initial treatment of pleural effusions until reaching a definitive diagnosis.

Hepatitis A virus (HAV) is one of the most common health problems worldwide and has the highest prevalence in societies with low to moderate social class. The aim of this study was to evaluate the prevalence of hepatitis A antibody in the patients admitted to the psychiatric ward of Sina hospital, Hamadan, Iran. In this descriptive cross-sectional study, 270 patients hospitalized in the psychiatric ward of Sina hospital were evaluated in 2015. Blood samples were analyzed by ELISA method and the HAV IgG antibody were measured in them. SPSS software version 16.0 was used to analyze the data. Hepatitis A test result was positive in 70.4% of the participants. The per capita income, household size, sex, educational level, place of residence, and occupational status were not significantly different between the patients who were seropositive for the hepatitis A antibody and HAV negative patients (P <0.05). The highest incidence was observed in the people with mood disorders. However, there was no difference in the type of disease between the patients who were seropositive for the IgG antibody and the HAV negative patients. Based on the results, the prevalence of HAV among urban and rural populations was not significantly different. The study patients were seropositive for IgG antibodies for HAV in the rates similar to those of populations with high prevalence of the disease, indicating a low level of health status in the community.

The main goal of the treatment of the hepatitis C virus (HCV) infection is reduction and elimination of viruses as well as achieving high sustained viral response (SVR). The present study aimed to assess response to treatment of HCV infection by focusing on virological and biochemical aspects.
This study was performed in Hamadan, Iran on HCV infected patients who were referred between 2009 and 2013. All participants were under the treatment with Pegylated Interferon (PEG-IFN) and Ribavirin (RBV). The duration of treatment varied based on the HCV genotype as 24 weeks for genotypes 2 and 3, and 48 weeks for other genotypes.
Of the 186 patients with HCV infection, 52.8% had a genotype of 3a and 35.6% had a genotype of 1a/b. Three months after treatment, 75 patients were willing to do quantitative PCR and early virologic response was observed in 58 cases (78.4%). Also, 112 patients were assessed after completing the treatment (75 patients in 24 weeks and 37 patients in 48 weeks treatment protocol) and the end-of-treatment response (ETR) was 94.7% and 86.5% respectively. Amongst the 103 patients with ETR, 76 were followed up six months after treatment and the PCR was negative in 71 cases (SVR = 93.4). With the progress and completion of the treatment, improvement is observed in liver function tests.
Even with the introduction of new drugs and interferon free protocols in treatment of hepatitis C infection it seems that the IFN-based treatment is still used in low/middle income countries for treatment-naive patients with HCV genotype 3.

Previous studies have documented a high prevalence of hepatitis E among patients undergoing maintenance hemodialysis. Available studies reporting on the seroprevalence of hepatitis E in hemodialysis patients in Iran, an endemic region for the disease, are sparse.. The present study aimed to determine the prevalence rate of anti-hepatitis E antibody in hemodialysis patients in Hamadan, Iran..Patients and In this cross-sectional study, all 153 consecutive patients undergoing hemodialysis in two centers were enrolled. Patients’ demographic and clinical data were collected, using a standard questionnaire and from medical records. Serum immunoglobulin G concentrations against hepatitis E were determined using the enzyme linked immunosorbent assay method.. Thirty patients (19.2%), were seropositive. Seropositive patients were not significantly different from seronegative patients, with regard to age, sex, level of education, access to filtered water, and duration and frequency of hemodialysis. The proportions of patients with hepatitis B, C, and HIV infection were comparable between the two groups.. One in five patients undergoing maintenance dialysis in Hamadan is seropositive for hepatitis E immunoglobulin G antibody. Future studies are needed to investigate the factors contributing to the observed high prevalence rate and the possibility of parenteral transmission of hepatitis E..

Hepatitis E virus (HEV) infection is a self-limited hepatitis and the most common cause of acute adult hepatitis in Asia. Young adults and middle-aged populations are more likely to be infected than other age groups.. The aim of this study was to determine the seroprevalence of anti-HEV among injection drug users (IDUs) compared to non-IDUs..Patients and This was a cross-sectional study performed on 131 IDUs referred to Farshchian Hospital, Hamadan, Iran and 131 non-IDUs selected from healthy visitors between March 2011 and March 2012. Anti-HEV IgG was measured in serum by ELISA method (DiaPro, Milan, Italy). Data including age, gender, education, location and duration of injection drug used were collected using a questionnaire.. In this study, the seroprevalence of hepatitis E virus antibody among IDUs group was 6.1%, and 1.5% among non-IDU group (Odds Ratio = 5.48; CI = 1/069-22/84), indicating that injection drug users were almost five and a half times more than non-IDUs at risk of HEV infection (P = 0.053). There was no significant association between seroprevalence of hepatitis E virus and education level (P = 0.46), duration of injection (P = 0.38) and location (P = 0.19).. Seroprevalence of hepatitis E virus among IDUs group was higher than non-IDU group, which might be due to possible blood transmission of HEV among IDUs..

Chlamydia pneumoniae has been linked with increased risk of cardiovascular diseases; however, data on stroke and cerebrovascular accidents are sparse.. The aim of this study was to determine the association between C. pneumoniae infection and ischemic stroke..Patients and In a case-control study, 141 patients, admitted with ischemic stroke, were compared with gender and age-matched control subjects (n = 141). Using an enzyme-linked immunosorbent assay kit, the presence of C. pneumoniae IgG and IgA in the patients’ sera was determined. The data were analyzed by SPSS software (version 15) and were compared between the two groups using T-test and chi square test.. The mean ages of the case and control groups were 68.97 ± 12.29 and 66.95 ± 6.68 years old, respectively. The difference between these two groups was not statistically significant (P = 0.102). The seroprevalence of C. pneumoniae-specific IgG were 78.7% in the patients with stroke and 52.5% in the control group. The difference between the two groups was statistically significant (P = 0.0001). The seroprevalence of C. pneumoniae-specific IgA were 41.1% in the stroke and 15.6% in the control group. The difference between the two groups was statistically significant (P = 0.0001).. The results supported the hypothesis that serological evidence of C. pneumoniae infection may be associated with an increased risk of ischemic stroke and cerebrovascular accident..

Hepatitis B is one of the most common chronic viral infections worldwide, especially in developing countries. The insufficient treatment of the disease increases the risk of cirrhosis and hepatocellular carcinoma, which impose heavy costs to the patient and the society. Different studies evaluated several protocols for the treatment of the disease.. The aim of this study was to evaluate the response rate of the different treatments in patients with chronic hepatitis B (CHB)..Patients and In a cross-sectional study, 89 patients with CHB who were referred to Infectious Diseases Clinics during 2004 to 2009 were studied. Serological and biochemical outcomes to the different treatments were evaluated. The data were analyzed by SPSS 16.. CHB was more frequent in men (74.2%) than women (25.8%). The mean age of the patients was 36 ± 1.36 years. Fifty-three patients (59.6%) had active CHB while 36 (40.4%) were asymptomatic carriers. Serologic and biochemical responses to the treatment were 50% and 69.44%, respectively. However, 50% of the patients with positive HBeAg showed serologic response to the treatment, 37.5% showed HBeAb as well as reduced amounts of HBeAg, and 12.5% just showed reduced amounts of HBeAg. Patients treated by lamivudine showed the highest serologic response rate (75%).. Serologic and biochemical response to the different treatments in the patients were better than other similar studies. Besides, it is recommended to begin antiviral therapy against CHB infection with lamivudine alone as a first-line therapy..

One-third of the world’s population is currently infected by tubercle bacillus. This study was performed to evaluate epidemiological and clinical aspects of confirmed cases of tuberculosis infections in a seven-year time period، between years of 2002 to 2008، in the city of Hamadan، west of Iran. In this descriptive retrospective study، medical records of 375 patients from the year of 2002 to 2008 were evaluated and analyzed. Required data were obtained from medical records of all the patients and inserted into a detailed checklist. Obtained data were analyzed by using SPSS statistical software (version 11. 0). The mean age of the patients was 53. 69±20. 37. Most patients were female (58. 7%). 78. 1% of the cases were from urban areas. 58. 7% of the patients were diagnosed by pulmonary tuberculosis. The mean age of the patients with extra-pulmonary tuberculosis was significantly younger than patients suffering from pulmonary tuberculosis. 29. 1% of males and 47% of females had extra-pulmonary tuberculosis. 72. 2% of the patients with pulmonary tuberculosis had a positive-sputum smear. Most patients with positive-smear for pulmonary tuberculosis were diagnosed (53%). Sputum culture was the most frequent diagnostic technique used in patients with negative-sputum smear. In patients suffering from extra-pulmonary tuberculosis، lymph node involvement was the most frequent (34. 2%). 44 patients (11. 7%) were expired. Due to the increasing number of tuberculosis infections from 2005 to 2008، it is important for the health care providers and department of public health to monitor and pursue screening and prevention guidelines closely.

Chest x-ray has an important role in the diagnosis of tuberculosis (TB). The aim of this study was to determine the radiological changes in patients with smear positive pulmonary tuberculosis. In this study, 325 patients with smear positive pulmonary TB was enrolled. The affected lobe or lobes of the left or right lung were recorded. The types of involvement were categorized based on patchy consolidation, cavitation, collapse consolidation and bronchopneumonia. The data were collected and analyzed. From the 325 patients, 116 (35.7%) were males and 209 (64.3%) were females. The most frequent involved site was the left upper lobe in 175 (53.8%) followed by the right upper lobe in 134 (41.2%) cases. The most frequent radiographic finding was bronchopneumonia in 242 (74.4%) cases. Patchy consolidation in 99 (30.4%), cavitary lesion in 68 (20.9%) and pleural effusion in 35 (10.7%) patients were seen. The results show that pulmonary upper lobes were the most frequent involved sites

Hepatitis includes a wide range of clinical and pathological conditions. The beta-2 microglobulin (ß2M)، as part of the HLA complex، is responsible for transmission of viral antigens on the surface of liver cells. The purpose of this study is to determine the concentration of salivary ß2M as a marker of viral proliferation in subjects who are HbsAg+، HBV DNA PCR+ compared with those who are HbsAg+، HBV DNA PCR-.

In this case-control study، we enrolled 25 patients who were Hbs Ag+، HBV DNA PCR+ in addition to 21 patients who were Hbs Ag+، HBV DNA PCR-. We obtained sputum samples from all patients and measured salivary ß2M levels by nephelometry. Data analyses were performed by the descriptive، student''s t- and chi square tests.

There were 25 men (54. 3%) and 21 women (45. 7%) with a mean age of 35. 72±11. 86 years who participated. Of PCR+ patients، 72% were on medication، however 85. 7% of the PCR- patients did not take medication (p<0. 001). Salivary Β2M concentration in the PCR+ patients (5. 28±5. 45) was greater than observed in the PCR- patients (1. 51±0. 77)، of which this difference was statistically significant (p<0. 003).

Salivary ß2M levels، as a marker of viral replication، could be used in patients with hepatitis B.

Brucellosis is one of the most common infectious diseases in some areas of Iran. Brucellosis has various clinical manifestations and should be considered in the differential diagnosis of many infectious and non-infectious diseases. The aims of this study were to determine the epidemiological, clinical and laboratory findings of the disease in patients with brucellosis in Hamadan, west of Iran. In this cross- sectional study, 230 brucellosis patients admitted in Farshchian Hospital in Hamadan from March 2005 to March 2010 were studied for epidemiological, clinical and laboratory characteristics of brucellosis. The patients who had manifestations compatible with brucellosis and standard tube agglutination test or Coombs test ≥1/80 plus 2ME ≥1/40 were enrolled. Data were analyzed using SPSS statistical package, version 15. About 43.5% of patients were female with mean age of 40.84 yr old. 27.8% of cases were living in urban and 72.2% in rural areas. The most contagious seasons were spring and summer. The most common transmission way was consuming of contaminated dairy products (60.3%); however, 39.7% of patients had a history of animal contacts. The most common symptoms were fever (77.4%), arthralgia (70%), sweating (47%), malaise and fatigue (46.5%). The most common clinical signs were fever and peripheral arthritis. Leukocytosis and elevated ESR (>20 mm/h) were reported in 20.8% and 59.5% of cases, respectively. Elevated CRP was detected in 52.9% of patients. Brucellosis should be considered in the differential diagnosis of patients with prolonged fever, spondylitis or peripheral arthritis in endemic areas.

Micronutrients such as zinc (Zn) and copper (Cu) have a modulatory effect on immune system. Altered serum concentrations of these nutrients have been described in patients with specific disease conditions. The aim of this study was to evaluate serum Zn and Cu level alterations in patients with brucellosis in comparison with healthy individuals. Patients and Serum Zn and Cu level of 43 patients with brucellosis (34 men and 9 women) were compared with 43 matched healthy controls. Serum micronutrient concentrations were measured by automatic absorptive spectrophotometry. Mean serum Cu concentration was significantly higher in subjects with brucellosis when compared with age-matched healthy controls (p

Immunodeficiency duo to HIV infection can produce unusual diseases in infected individuals & CD4 count is the main predictor of disease progression. In this study clinical syndromes resulting in admition, are considered according to CD4 count for the beter diagnosis and treatment of clinical problemes in HIV infected patients.Materrial & This is a cross - sectional study that was performed since March 2002 to March 2003 in Kermanshah Sina Hospital. HIV infection was confirmed with positive duble ELI SA and Western Blot. CD4 count was measured by flucytometery, clinical syndromes were collected with final diagnosis, and the rest of the data were gathered according to the patients'' interviews. Statistical analysis was performed by SPSS 11.5. During this study, 72 out of 215 admssions were enrolled. All of them were male with the mean age of 33.4 9.1 years. 64 cases (88.9%) were addicted and 40 cases (55.6%) had prison history. Clinical and/or laboratory indicators of AIDS were observed in 32 cases (44.4%). The average of CD4 count was 356/μL.Patients with lymphadenopathy, neurologic and pneumonia syndromes had the least count of CD4 with the averages of 90, 241 and 269/μL and patients with sepsis, endocarditis and hepatitis syndromes had the highest CD4 average count of 646, 394 and 373/μL respectively. Statistically correlations wereobserved between pneumonia syndrome with CD4<200/μL(Pvalue=0.005), and addiction history(Pvalue =0.0001). Suffering from hepatitis syndrome was also statistically correlated with being at prison. High prevalence of AIDS in our study was a trait which means high prevalence of asymptomatic HIV infection in general population. Also in patients with CD4<200/μL, especially those who are addicted, pneumonia syndrome may occur. Lymphadenopathy, neurologic and pneumonia syndromes are more common in CD4<300/μL whereas sepsis, Endocarditis and hepatitis syndromes are common in CD4> 300/μL, that shows the effect of CD4 count in appearance of clinical syndrpmes. Unsafe injections in prisons may cause acquisition of viral hepatitis in these patients.