جستجوی مقالات مرتبط با کلیدواژه « توبرکلوزیس » در نشریات گروه « پزشکی »

Prisoners are among the high risk population for contagious infections such as HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C Virus), TB (Tuberculosis), and other dangerous diseases. In spite of other countries in the world, data about the prevalence and risk factors for infectious diseases among prisoners are spars in Iran. The aim of this study was to determine the prevalence of HBV, HCV and TB coinfections among male prisoners suffering from HIV.

In this descriptive-analytical study, 100 HIV patients were selected. Microscopic examination (acid fast staining) was applied on sputum specimens and serological (HBsAg, anti- HCV) and molecular (Real time PCR and DNA sequencing) investigations carried out on patient’s sera.

Among 100 prisoners affected with HIV, the prevalence of HCV, HBV and TB infections were 45%, 3%, and 9%, respectively. All HBV positive cases were genotype D, subgenotype ayw2. Among the HCV positive subjects, 34 (75.5%) and 11 (24.5%) were genotype 1a and genotype 3a, respectively. There was no significant relation between age, CD4 and transmission route of HCV in male prisoners affected with HIV. Drug injection was the main route for the acquisition of HCV, HBV infections.

This study showed that a high prevalence of HCV and TB infections among male prisoners affected with HIV.

Pleural effusion is the most common form of extra-pulmonary tuberculosis. With the advancement of endoscopic techniques, thoracoscopy has been identified as a diagnostic procedure for Pleural TB. The aim of this study was to evaluate the thoracoscopic manifestations of pleural tuberculosis and its association with the pathological findings of pleural tuberculosis.
In this cross-sectional study, 85 patients with unexplained exudative pleural effusion were studied over a period of 12 months. Patients with general anesthesia underwent thoracoscopy. Multiple biopsies were obtained from pleura and were evaluated using pathological examination.
Based on the pathology results, the patients were divided into two groups with the final diagnosis of TB as group 1 (40 patients) and other diagnoses as group 2 (45 patients). Thoracoscopic findings of group 1 included pleural effusion, multiple nodules, adhesion, Caseous necrosis, thickening, pleural edema, and single plurilateral nodules were found in 100%, 70%,67.5%, 60%, 30%,17.5% and2.5% of cases, respectively. Among these findings, caseous necrosis, multiple nodules, adhesion, thickening, and pleural edema had a statistically significant association with the ultimate pathological findings of TB.
In cases of suspicion of pleural TB, Thoracoscopy and direct pleural observation and multiple biopsies of the pleura are suitable methods. In the case of caseous necrosis, multiple nodules, adhesions, thickening, and pleural edema may be suspected in the presence of tuberculosis.

Central nervous system (CNS) tuberculosis (TB) is one of the extrapulmonary manifestations of mycobacterium tuberculosis. Cerebrovascular accidents and cerebral abscesses in children constitute 5 to 18.7% of all cases. Therefore, a child with congenital heart disease (Tetralogy of Fallot) and neurological manifestations consistent with brain abscess and suffered from CNS tuberculosis.
CASE PEPORT: The patients is a 10-year-old boy with Tetralogy of Fallot who underwent ceftriaxone, vancomycin and anticonvulsant treatments with initial suspicion of central nervous system infection and with symptoms of fever, seizures and decreased consciousness. Due to observation of cerebral edema and several lesions in brain parenchyma in CT scans in the form of abscess, corticosteroid and metronidazole was added to the treatment process and the patient underwent cerebrospinal fluid analysis. Considering low sugar of cerebrospinal fluid, improved brain image and at the same time, lack of clinical recovery, we suspected mycobacterium tuberculosis. Therefore, the cerebrospinal fluid PCR was sent and the experimental anti-tuberculosis treatment started. Finally, the result was positive in terms of mycobacterium and anti-tuberculosis treatment continued.
Tuberculosis as the cause of disease manifestations in endemic areas should always be taken into consideration. To justify patient symptoms with more common causes, one should not discard other diagnoses; because early diagnosis of CNS tuberculosis prevents certain death.

HLA disease association was investigated in several autoimmune, cancer and infectious diseases. The outcome of tuberculosis (TB) infection may be influenced by host genetic factors like MMP-1, MCP-1, IL-10, IL-12, TNF-α, IFN-γ and human leukocyte antigen (HLA). Given the paucity of information with regard to the association between the human leukocyte antigens (HLA) and TB infection among Iranians, we aimed to identify HLA polymorphisms that might confer susceptibility or protect against TB.
In this case-control study, to investigate the association between the HLA-DRB1 and DQB1 alleles and TB, 50 patients with tuberculosis were selected from Sistani population in Golstan University of Medical Sciences, Golestan Province, North East of Iran, from September 2015 to February 2016. Allele frequencies in patients were compared with a 100 aged and sex match control group from healthy blood donor of that ethnic population. HLA-DRB1 and -DQB1 alleles were determined using polymerase chain reaction based on sequence specific primer (PCR-SSP) method by low to intermediate resolution kits supplied by CTS (Collaborative Transplant Study, Heidelber University, Germany). Using EPI-info statistical software Chi-square test and fisher exact test, 95% confidence interval and odd ratio were calculated and allele frequencies in patients and control subjects were compared. P-value less than 0.05 were considering statistically significant.
The results of this study showed a significant increase and positive association with -DRB1*04:03 (OR=3.13, CI 95% (2.47-3.96), -DRB1*14:04 (OR=3.13, CI 95% (2.47-3.96), -DQB1*0201 (OR=2.67, CI 95% (1.18-6.04), -DQB1*0601 (OR=3.16, CI 95% (1.36-7.73) ,while the frequency of -DRB1*07 (OR=0.16, CI 95% (0.05-0.52) were lower in patients than control group and shows negative association.
The results of this study confirmed some of the previous positive and/or negative association, however it is suggested that HLA-DRB1*04:03, -DRB1*14:04, -DQB1*0201, -DQB1*0601- have an important role in susceptibility to tuberculosis infection and -DRB1*07 was associated with protection in Iranian Sistani population. Larger case-control sample size studies may be helpful to confirm our investigation. In addition population-specific studies is needed for evaluation of the role of HLA polymorphisms in tuberculosis in different ethnic groups.

Tuberculosis is one of the most significant public health problems. In this paper, the treatment outcome of TB patients referred to Faculty of Medical Sciences and Health Services of Iranshahr, for the evaluation of the treatment strategies efficacy was studied.
This study was a retrospective cross-sectional and the data were collected through census method. Descriptive analysis was used for qualitative and quantitative variables and chi-square tests, t-test, and logistic regression were used for other comparisons.
In this study, 1621 patients were investigated that 49.7% of them were male and the rest were female. Bivariate analysis between gender, age, weight, disease type, sputum smear result (beginning, second month, fourth month, and end of the therapy), residing in prison, new case, nationality, and HIV infection showed statistically no significant relationship with the treatment outcome. According to logistic regression analysis, the relationship between smear result of the patients at the end of the second month and treatment outcome was not significant, but there was a statistically significant relationship between the results of two months after maintenance treatment beginning and the treatment outcome.
Short-term standard treatment strategy under direct supervision, treatment monitoring, ensuring treatment compliance, following-up treatment of travelers and migrants, and proper nutrition would be effective to achieve optimal outcome. Key words: Tuberculosis, Treatment outcome, Iranshahr Key words: Tuberculosis, Treatment outcome, Iranshahr

Although Tuberculosis (TB) is prevalent in developing countries، visceral TB is rare. Most cases of pancreatic tuberculosis are seen in association with disseminated TB (miliary) but isolated pancreatic infection is very rare. Especially when present in immunocompetent hosts. In clinical and radiological evaluation، pancreatic TB may present as a pancreatic abscess، acute or chronic pancreatitis، and cystic or solid pancreatic masses، so can confused with neoplasm in most cases. In winter of 2013، a 52-year-old woman was admitted to this hospital with epigastric pain. She also mentioned a history of weight loss during previous three months. Liver transaminases and total bilirubin were within normal range. Chest X-ray performed was negative for any cardiopulmonary process، and lung fields were noted to be clear. A purified protein derivative (PPD) skin test for tuberculosis yielded an induration of less than 1 centimeter. An abdominal CT- scan with IV and oral contrast was done. A 2×2 cm mass was seen in the pancreatic head. A diagnostic laparotomy was done. During surgery، a completely necrotic mass was in the pancreatic head. samples were sent for frozen section. The tuberculosis granuloma was diagnosed. Four drug anti-tuberculosis medication was started and continued for six months. Repeat imaging of the abdomen performed 6-months after the initiation of anti-TB therapy revealed complete resolution of the pancreatic mass، and antitubercular therapy was discontinued after a 6-month duration. Pancreatic tuberculosis can present with a variable spectrum of imaging findings. Furthermore، TB should be considered as a cause of any suspicious pancreatic lesion، especially in patients from areas where the infection is endemic.

Tuberculosis (TB) has been remained as a major health problem. The most commonly used diagnostic tool for TB is a simple skin test. However, it has some disadvantages and it`s specificity can be compromised. Hence, detection of Mycobacterium tuberculosis specific antibodies in human sera has been considered as an important diagnostic test. In this study, humoral immune responses against recombinant CFP-10 protein of Mycobacterium tuberculosis in 51 patients with TB and 39 healthy subjects were evaluated using indirect enzyme-linked immunosorbent assay (ELISA). From 51 positive serum samples, 47 were positive and from 39 negative serum samples, 33 showed negative results. In this study, sensitivity and specificity of test were 92.15, 84.61 percent for dilution of 1:10 and 64.70 and 97.43 percent for dilution of 1:100, respectively. Accordingly, the estimated cut-off point was 0.351 and. 025 for dilutions of 1:10 and 1:100, respectively. Our data suggested that the levels of antibodies against CFP-10 antigens in patients with TB were significantly higher than those in healthy subjects. This study demonstrated that ELISA with the use of the CFP-10 recombinant antigens is simple and sensitive and can be used to analyze large numbers of samples for the serodiagnosis of TB.

Tuberculosis is the second factor in the deaths caused by infectious diseases in the world. Out of every ten infected people, only in one the clinical symptoms of the disease is developed. The correct vitamin D receptor activity on the nuclei of macrophages is one of the main components of the host innate immunity against M. tuberculosis. In the present study, the relationship between FokI polymorphism in the vitamin D receptor gene and tuberculosis has been investigated. The subjects were 76 patients with tuberculosis and 81 healthy controls. The genomic DNA was extracted from the blood leukocytes of all study participants, and amplified by PCR technique. Then the RFLP process was performed on all PCR products and the FokI polymorphism region was studied. The frequency of each of allele and genotypes was specified in the case and control groups and then analyzed by Chi-square test. The frequencies of FF genotype were 52.4% and 55.6% in patient and healthy groups, respectively, and also, ff genotype were 8.3% and 8.9% in patient and healthy groups; (OR= 0.99, 95% CI 0.33 – 2.96, P= 0.99). These differences in frequency between them were not statistically significant. In this study, there was no statistically significant relationship between allelic and genotype frequency of FokI (F/f) polymorphism in VDR gene and susceptibility to tuberculosis in the respective statistical society.

Background and Aspergillus is a ubiquitous fungus، which causes a wide spectrum of infections including invasive pulmonary aspergillosis (IPA)، depending on the patient’s immune status and underlying lung disease. Among the Aspergillus spp، A. fumigatus remains the predominant agent of IPA. In patients with a preexisting lung cavity from a variety of causes، such as pulmonary tuberculosis (TB) Aspergillus can colonize and grow into the cavity to form a pulmonary aspergilloma. In this present study we assessed TB patients for aspergilloma based on culture and non-culture based methods. During one year، we studied 124 patients with TB at Massih Daneshvari hospital from Tehran، Iran. Sputum specimens were analyzed by direct microscopic examination (DME) with 20% potassium hydroxide. These samples were also processed for fungal culture. The clinical and radiological features or CT-scan report of all patients were recorded. All patients were screened for serum specific IgG against A. fumigatus، using Aspergillus IgG ELISA Kit (Genesis Diagnostics Ltd، Cambridgeshire، UK). The results are expressed in U/mL. IgG 12 U/mL was considered as positive result based on kit manufacturer instruction. Out of 124 patients with tuberculosis (66 male، 58 female، age range: 10-91 years)، 54 had abnormal chest radiographic findings. Chest X-ray findings showed that 48 patients 38. 7%) exhibited residual cavities (31 cases in right lobe، 10 in left lobe and 7 in both lung). Round shaped mass lesion was detected only in 6 patients (6. 8%). DME of sputum was positive in 10 patients for septate fungal hyphae. A. fumigatus was grown from 14 samples of TB patients. Out of 124 TB patients، 55 (44. 3%) cases were positive for specific serum IgG against A. fumigatus. There was a significant relationship between positive culture، DME and serum IgG profile level (P< 0. 05). Totally، three patients (2. 4%) met criteria for aspergilloma Colonization with Aspergillus in preexisting lung cavity produced by TB should be considered as a risk factor for aspergilloma.

Natural Killer (NK) cells، through mechanisms such as cytotoxicity and cytokine production، are among the first line of defence against infections. The ability of NK cytotoxicity is related to Killer cell immunoglobulin-like receptors (KIR) found on the cell surface. Interaction between KIRs and human leukocyte antigen (HLA) class I molecules regulate NK cells responses to eliminate infected cells. Therefore، in continuation of a preliminary study، the aim of this supplementary study was to investigate the impact of KIR genes، HLA ligand genes، and KIR-HLA combinations on susceptibility to tuberculosis (TB) in Lur population. The genomic DNA of 50 patients with TB from Lorestan province was genotyped for sixteen KIR genes and their five major HLA class I ligands by a polymerase chain reaction-sequence specific primers (PCR-SSP) assay. Finally، these results were compared with those of 100 healthy Lur individuals. In this study، the frequency of KIR3DS1 was significantly higher in the control group than the patient group (45% vs. 24%، Pc=0. 0204). Also، KIR3DS1+HLA-B Bw4Ile80 combination was more frequent in control individuals compared to TB patients (25% vs. 4%، Pc=0. 0034). These findings imply a genetic imbalance between activating and inhibitory KIR genes and KIR-HLA combinations in TB patients of Lur population. Low level of activating KIRs and particularly KIR3DS1 and its combination with HLA-B Bw4Ile80 ligand might have an influence on the susceptibility to TB in Lur population. Indeed، these findings confirmed the results of our preliminary study.

It is estimated that one third of the world’s population is infected by M. tuberculosis. Because of differences in immune system activity against the invasive microorganisms، the disease is developed only among 10% of them. Vitamin D metabolism and its receptor activity are important factors in human native immune system against tuberculosis. In the present study we investigated ApaI polymorphism of vitamin D receptor (VDR) gene and association with susceptibility to tuberculosis. This study was performed on 84 cases with tuberclosis (male =50، female =34) and 90 controls (male =49، female = 41). DNA was extracted from cases and controls leucocytes and elected sequences amplified in polymerase chain reaction (PCR) procedure by using specific primers. ApaI polymorphism of VDR gene evaluated by RFLP technique on PCR products. Finally statistical analysis performed using Chi- square to compare genotype frequencies between cases and controls. In case and control groups، AA genotype frequency were 34. 5% and 33. 3% respectively (OR=0. 905، 95% CI 0. 469-1. 747، p = 0. 766) and a genotype frequency in patients and control group were 15. 47% and 13. 3% respectively (OR=0. 808، 95% CI 0. 333 1. 961، p=0. 637). In the present study we could not find any significant relationship between genotype frequency of ApaI (A/a) polymorphism in VDR gene and susceptibility to tuberculosis.

T. B (Tuberculosis) is one of the oldest diseases and it has been considered as one of the causes of human mortality and morbidity. Some of TB patients simultaneously are involved with other co morbidities such as leishmaniasis، and it slows down the treatment procedures of the secondary disease. Case Report: This study was about a TB patient with more than seven leishmaniasis active lesions in her ferent organs. The patient was a 73 years old female residing and from Moshk-Abad village from the central county of the Qom province who referred to Qomrood health care center for treatment for the first time. We became suspicious to TB because of the poor healing of the leishmaniasis lesions and also positive history of cough for more than two weeks and severe cachexia. The sputum samples were obtained and sent to the laboratory، and all the three samples were positive for AFB (acid-fast bacillus) and besides meglomin antimonite، DOTS (Directly Observed Treatment Short course) was started for the patient. Based on findings of this study، in patients with cutaneous leishmaniasis which are drug resistant or failure to treatment، according to their clinical symptoms، other diseases that weaken the immune system such as tuberculosis should be considered.

Tuberculosis is one of the most important infectious diseases and a major cause of morbidity and mortality in developing countries. Multi drug resistant tuberculosis is a new threat, which can result in a high case fatality rate. This study was conducted to define the incidence of multidrug resistant tuberculosis in Kermanshah. ¬Antibiogram was performed on¬¬ PCR-confirmed isolates of mycobacterium tuberculosis by using the proportion method. Eight cases (57.1%) showed resistance to ¬1µg/ml Isoniazid¬. Resistance to Rifampicin was identified in 46.2% ¬of cases.¬ This study showed a high rate of single drug and multidrug resistance. We recommend antibiogram for all cases of tuberculosis.

Both CD4+ type 1 helper (Th1) cells and CD8+ T cells play effective roles in protection against Mycobacterium tuberculosis infection. MPB51, a major mycobacterial secreted protein, induces humeral and cellular immune responses against mycobacterial infection. In addition, DNA vaccine encoding MPB51 can induce cellular immune responses and protective immunity upon challenge with M.tuberculosis. This study address to identify T-cell immunodominant epitopes on MPB51 in BALB/c mice. We cloned DNA encoding MPB51 molecule in pCI plasmid. After constructing MPB51 DNA-covered gold cartridge, BABL/c mice were immunized by using a gene gun system. Two weeks after the last immunization, the immune spleen cells were cultured in response to synthetic overlapping library peptides covering the mature MPB51 sequence or medium alone. Intracellular and cell culture supernatant gamma interferon (IFN-) production was analyzed by using flow cytometry and ELISA, respectively. The findings of present study indicate that DNA vaccination can course strong mmune response only against the peptides contain 21-40 aminoacids. Further analysis with a computer – assisted algorithm permitted the identification of nine aminoacids of (P24-32) as immunodominant CD8+ T cell epitope. This study proved than the MHC class I-peptide (H2-Dd-P24-32) complex is recognized by (IFN-)–producing CD8+ T cells. We observed by using T-cell subset depletion that CD8+ T cells are the only P24-32-responded T-cells in BABL/c mice. The data obtained are useful for identifying cellular immune responses against TB and for designing a new vaccine against M.tuberculosis infection.

We studied the effect of different concentration of streptomycin in growth of Mycobacterium Tuberculosis strains. The results showed that in Streptomycin resistant and sensitive strains addition of 0.1 µg/ml and 0.01 µg/ml of Streptomycin in Lowenstein media, enhanced the appearance of colony about 5-7 and 1-5 days respectively. This observation may be due to the effect of Streptomycin on porin proteins of Mycobacterium Tuberculosis cell wall. Strains of M.tub showed modified colony morphology in the presence of low concentration of Streptomycin (0.1 & 0.01 µg/ml).