Papers by shokrollah salmanzadeh
Journal of Kerman University of Medical Sciences, Apr 25, 2023
Introduction Coronaviruses (CoVs) are enveloped, non-segmented, positive-sense RNA viruses which ... more Introduction Coronaviruses (CoVs) are enveloped, non-segmented, positive-sense RNA viruses which belong to the family of Coronaviridae, the order Nidovirales, and the genus Coronavirus (1,2). The coronavirus subfamily is further divided into four genera: alpha, beta, gamma, and delta coronaviruses (3,4). Coronaviruses are a large family of viruses causing illnesses ranging from the common cold in adults to gastrointestinal illness in children (5). Since December 2019, an acute respiratory infection caused by a new type of coronavirus in Wuhan, China (later called COVID-19), which rapidly spread all over China and the world, has become a new global public health crisis (6,7). COVID-19 can cause symptoms including cough,
Iranian Journal of Clinical Infectious Diseases, Jun 27, 2023
Background: Brucellosis, also known as malt fever, poses significant health and economic challeng... more Background: Brucellosis, also known as malt fever, poses significant health and economic challenges across various regions worldwide, particularly in Mediterranean and Middle Eastern countries. Objectives: This study aimed to identify cases of undiagnosed brucellosis among psychiatric patients. Methods: This descriptive cross-sectional study was conducted at Golestan Hospital in Ahvaz, Khozestan Province, Iran. The study aimed to investigate cases of undiagnosed brucellosis among psychiatric patients during the first six months of 2021. The diagnosis of brucellosis relied on standard tests, namely the Wright test, the Coombs-Wright test, and the two-mercaptoethanol test, which are widely recognized as reference techniques. In the endemic region of Iran, a positive titer of at least 1: 80 in the Wright test and titers of at least 1: 40 in the two-mercaptoethanol test are considered diagnostic criteria. The Coombs-Wright test is deemed positive when the titer is three dilutions higher than the Wright test titer in symptomatic patients. Results: A total of 225 patients admitted to psychiatric wards with psychiatric disorders underwent examination for brucellosis. The study revealed an undiagnosed brucellosis prevalence of 7.6% (n = 17). None of these patients had a recent or prior history of brucellosis, nor had they received any treatment for the disease. Among the seventeen patients, three reported experiencing typical and commonly observed symptoms of brucellosis, such as myalgia and arthralgia, during the clinical interviews. However, the remaining fourteen patients did not display any clinical symptoms typically associated with brucellosis, including myalgia, arthralgia, fever, and sweating. Instead, they solely exhibited psychiatric symptoms alongside their condition. Conclusions: Based on the findings, it can be deduced that among the 225 patients diagnosed with psychiatric disorders, 14 individuals were identified as having brucellosis. Remarkably, these patients did not exhibit the characteristic symptoms typically associated with brucellosis. Instead, their manifestation of brucellosis presented solely as psychiatric symptoms.
PubMed, Mar 1, 2017
Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum t... more Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum toxin. The main manifestations are flaccid muscle paralysis and cranial nerve palsies. Botulism is an essential health problem because of its high mortality. The diagnosis of botulism, especially in sporadic cases, is a medical challenge and a high clinical suspicion is necessary for early recognition. So, every physician should be familiar with its signs and symptoms for early detection and treatment. We describe a family with dysphasia and acute paralysis after the ingestion of locally made cheese. The clinical presentations of the 1st patient were similar to myasthenic crisis and she, therefore, received plasma exchange. After the appearance of similar symptoms in the other family members, they were treated with polyvalent botulinum antitoxin and diagnosis was confirmed by toxicology and detection of serotype A botulinum toxin in cheese and stool samples. Uncommon clinical presentations and unusual sources of botulinum toxin should be kept in mind because of the importance of early diagnosis and treatment.
PubMed, 2014
Background: Soil dust has been debated about its effects on public health and the challenge is br... more Background: Soil dust has been debated about its effects on public health and the challenge is brought about tuberculosis (TB). The purpose of this study was to investigate the influence of soil dust on pulmonary tuberculosis (PTB) prevalence and its control indices. Methods: The medical files of patients in Khuzestan Health Center were reviewed. The control group included the PTB patients registered from 2005 to 2006 (before soil dust), and case group consisted of PTB patients who were registered from 2007 to 2010 (after soil dust exposure). The diagnosis of tuberculosis was based on National Tuberculosis Program (NTP). Results: The mean age of control and case group was 42 (18-80) years and 40 (13-99) years, respectively. The prevalence of pulmonary TB in the control and case group was 537 (12.5 per 100000 population) and 465 (11.0 per 100000 population), respectively. Exposure to dust did not increase the prevalence of TB. The prevalence was higher in women than men (298, 41.8% vs. 336, 48.2%), in children than adult group (31, 4.3% vs. 53, 7.3%), in urban than rural inhabitants (448, 63% vs.496, 71.1%) and in family contacts than solitary contamination (60, 8.4% vs. 97, 13.9%). The rate of treatment failure, TB relapse, and MDR-TB in controls and cases were (1.4%, 1.4%, 1%) and (7%, 5.5%, 4.6%), respectively. Dust exposure had significant effect on treatment outcome. Conclusion: Although soil dust exposure had no significant effect on TB prevalence, but significantly affected the prevalence of TB respecting to age, sex, residential area and closed contact. In addition resulted in more treatment failure, development of MDR TB and relapse.
DOAJ (DOAJ: Directory of Open Access Journals), 2016
Background: Prompt diagnosis and treatment of latent tuberculosis (TB) infection (LTBI) are neede... more Background: Prompt diagnosis and treatment of latent tuberculosis (TB) infection (LTBI) are needed to control TB. The aim of the study was to compare the performance of Quanti FERON-TB test (QFT) with conventional TST for the diagnosis of LTBI. Methods: In this analytical-comparison study, we enrolled 87 nurses working in teaching hospitals in Ahvaz. All study subjects were tested by TST. TST results were interpreted as positive if induration was more than 10 mm. If the level of QFT after stimulation was equal or greater than 0.35 IU/ml, test was considered as positive. Data were analyzed with SPSS program. QFT results compared with induration in TST and its relation to all variables were investigated. Results: The rate of LTB diagnosis by TST and QFT was 31% and 35.6%, respectively. There was no significant difference between TST and QFT in LTB diagnosis (P=0.62). Among the 56 subjects who were TST-negative, 14 cases (approximately 25%) were QFT-positive and 42 (75%) were QFT-negative. Among the 31 cases (35.6%) that had TST-positive, 13 (42%) were QFT-positive and 18 (58%) were QFT-negative. The overall percent agreement was 63.2% (k=0.139, P=0.69), discordance %=15.9-20.7, sensitivity= 41.5% and specificity=75.5%. Conclusion: Diagnostic value of QFT is similar to TST, when there is strong clinical and epidemiological evidence of LTB in a nurse with negative TST, adding QFT to diagnostic evaluation is associated with increased rate of LTB diagnosis.
PubMed, Aug 10, 2007
This study investigated the frequency of Escherichia col, Shigella and Salmonella species in stoo... more This study investigated the frequency of Escherichia col, Shigella and Salmonella species in stool specimens from patients with diarrhoea presenting to health centres in Hamedan province, Islamic Republic of Iran. From 144 samples, Shigella strains were isolated in 17 cases (11.8%): 10 Sh. flexneri, 3 Sh. sonnei, 2 Sh. boydii and 2 untyped strains. No Salmonella strains were isolated. Using molecular diagnostic methods, diarrheogenic E. coli were detected in 37 cases (25.7%), the majority were enterotoxigenic (ETEC) (22 cases) and Shiga toxin-producing (STEC) strains (15 cases). In 14 cases (9.7%) there was co-infection.
PubMed, 2015
Background: Knowledge about childhood tuberculosis (TB) in Iran is limited. This study aimed to d... more Background: Knowledge about childhood tuberculosis (TB) in Iran is limited. This study aimed to determine the proportion of tuberculosis in children living in Khuzestan in southwest of Iran and its treatment outcomes. Methods: In this retrospective study, the child's medical records registered in national TB program (NTP) unit of Khuzestan Health Center (KHC) for TB treatment from 2005 to 2010 were studied. Data including demographic, clinical presentation, laboratory test results, and treatment outcomes were extracted from the files and were analyzed. Results: Of total 4104 new TB cases registered in KHC, 203 (4.9%) were children. The mean age was 10.7±4.3 years, and 75.7% of them were females. More than 84% of TB children cases were 10 years or older, whereas, young children (< 5 years old) accounted for 5.6%. Of the total studied cases, 57.1% were pulmonary TB and 42.9% were extra pulmonary, 91.7% were successfully treated and 8.3% had poor treatment outcome. The main risk factors for poor treatment outcome were: age <5 years (OR: 0.17, 95% CI, 0.04-0.76), low body weight (OR: 0.08, 95% CI, 0.01-0.60), household contact with cases of TB treatment failure (OR: 0.13, 95% CI, 0.03-0.52), and exposure to cigarette smoke odor inside the home (OR: 0.17, 95% CI, 0.05-0.56). Conclusion: The proportion of pediatric TB in the region was lower than expected. The treatment success rate was higher than the rate defined in NTP. Special attention should be given to children aged less than five years, low body weight, contact with TB treatment failure cases, and exposure to cigarette smoke.
Journal of Voice, May 1, 2023
ObjectivesThe voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affe... more ObjectivesThe voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affected due to lower and upper respiratory involvement. Patient-based voice assessment scales are important clinical measures to diagnose voice disorders and monitor treatment outcomes in COVID-19 patients. This study compared vocal fatigue between COVID-19 patients and those with normal voices. Furthermore, the relationship between vocal fatigue and acoustic voice parameters of COVID-19 patients was evaluated.MethodsThis cross-sectional study enrolled 30 laboratory-confirmed patients with COVID-19 (18 males and 12 females) and 30 healthy individuals with normal voices (14 males and 16 females) to compare their respiratory or phonatory parameters. The Persian versions of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) and the vocal fatigue index (VFI) were conducted before and after reading the text. The Jitter, shimmer, maximum phonation time, and harmonic-to-noise ratio (HNR) were analyzed by Praat software based on the recorded voices of CAPE-V tasks. The acoustic assessment and VFI questionnaire results were compared between COVID-19 patients and the control group.ResultsThere were significant differences between COVID-19 patients and their healthy counterparts in all VFI subscales (P < 0.001). Moreover, after reading the text, we found significant differences between the two groups regarding Jitter, shimmer, and HNR of /a/ and /i/ vowels (P < 0.05). Our findings also indicated a significant correlation between symptom improvement with rest and acoustic parameters in all tasks, except the Jitter of /a/ before reading the text.ConclusionPatients with COVID-19 showed significantly more vocal fatigue than people with normal voices after reading the text. Moreover, there was a significant relationship between Jitter, shimmer, and HNR and the tiredness of voice and physical discomfort subscales of VFI.
Asian Pacific Journal of Tropical Medicine, 2021
Objective: To investigate the antimicrobial resistance patterns and prevalence of integrons in Sh... more Objective: To investigate the antimicrobial resistance patterns and prevalence of integrons in Shigella species isolated from children with diarrhea in southwest Iran. Methods: In this study, 1 530 stool samples were collected from children under 15 years with diarrhea referred to teaching hospitals in Ahvaz and Abadan, southwest Iran. Shigella spp. were identified by standard biochemical tests and PCR. The antibiotic resistance pattern of all Shigella isolates was determined by the disk diffusion method and minimum inhibitory concentration (MIC) by E-test. Results: Of 1 530 stool samples, 91 (5.9%, 91/1 530) were positive for Shigella spp. the most common Shigella isolates were Shigella flexneri 47 (51.6%, 47/1 530). Antibiotic susceptibility tests showed that the highest antibiotic resistance was related to trimethoprim-sulfamethoxazole (87.9%, 80/91) and ampicillin (86.8%, 79/91). Multiplex PCR results revealed that 56% and 86.9% of Shigella isolates carried integron class I and integron class II genes, respectively. None of the isolates included the integron class III gene. Conclusions: The high prevalence of multi-drug resistance in Shigella isolates in our area increases the concerns about dissemination of the antibiotic-resistant isolates in this bacterium.
Infection and Drug Resistance, Oct 1, 2018
Background: The emergence of drug resistance among Mycobacterium tuberculosis (MTB) strains is a ... more Background: The emergence of drug resistance among Mycobacterium tuberculosis (MTB) strains is a serious health concern worldwide. The development of rapid molecular diagnostic methods in recent years has a significant impact on the early detection of resistance to major anti-TB drugs in MTB isolates, which helps in employing appropriate treatment regimen and prevents the spread of drug-resistant strains. This study was designed to evaluate the efficacy of real-time PCR and high-resolution melting (HRM) curve analysis for the determination of resistance to rifampin (RIF), isoniazid (INH), and ofloxacin (OFX) in MTB isolates and to investigate their resistance-related mutations. Methods: HRM analysis was performed to screen 52 (32 drug-resistant and 20 fully susceptible) MTB clinical isolates for mutations in rpoB, katG, mab-inhA, and gyrA genes. The HRM results were then confirmed by DNA sequencing. Results: In total, 32 phenotypically resistant isolates, comprising 18 RIF-, 16 INH-, and five OFX-resistant strains, were investigated. HRM analysis successfully identified 15 out of 18 mutations in rpoB, 14 out of 16 mutations in katG and mab-inhA , and four out of five mutations in gyrA conferring resistance to RIF, INH, and OFX, respectively. The obtained sensitivity and specificity, respectively, for HRM in comparison with phenotypic susceptibility testing were found to be 83.3% and 100% for RIF, 87.5% and 100% for INH, and 80% and 100% for OFX. In five resistant strains (12.8%), no mutation was detected by using HRM and DNA sequencing. Conclusion: HRM assay is a rapid, accurate, and cost-effective method possessing high sensitivity and specificity for the determination of antibiotic resistance among MTB clinical isolates and screening of their associated mutations. This method can generate results in a shorter period of time than taken by the phenotypic susceptibility testing and also allows for timely treatment and prevention of the emergence of possible MDR strains.
Malawi medical journal, Apr 1, 2023
South Asian research journal of medical sciences, Jan 19, 2023
Purpose: Diabetes can increase oxidative stress in various tissues of the body, and the progress ... more Purpose: Diabetes can increase oxidative stress in various tissues of the body, and the progress of this process is associated with intensification of the complications of diabetes. The current study purposed to evaluate the protective effect of Pinus gerardiana (PG) seed on oxidative stress induced by diabetes in the liver and serum of streptozotocin (STZ)-induced diabetic rats. Materials and Methods: This interventional study was performed on 36 male Wistar rats. The rats were randomly divided into 6 groups (healthy controls, healthy treated with 3% and 6% (PG), diabetic control, diabetic treated with 3% and 6% (PG) doses). After 6 weeks of intervention, weight, glucose, and oxidative stress parameters in serum and liver including total antioxidant capacity, malondialdehyde, total thiol and superoxide dismutase activity were measured. Data analysis was done by statistical software version 16 and Tukey's oneway ANOVA tests. Results: Diabetic rats showed significantly higher malondialdehyde and fasting glucose levels (12±1.2 mmol/L) and significant reductions in fasting insulin serum, weight (−37%), and activity of superoxide dismutase enzymes, total thiol groups, and total antioxidant capacity of serum and liver (about +49% in liver and +16% in serum) (p < 0.001) compared with the healthy groups. Oral administration of PG nuts to diabetic rats caused a significant reduction in malondialdehyde and fasting glucose levels (−43%) and weight loss (+15%), and a significant increase in activity of superoxide dismutase enzymes, total thiol groups, and total antioxidant capacity of serum and liver (p < 0.001). Conclusion: The present study concluded that PG can decrease fasting blood glucose, improve insulin resistance, reduce weight loss, and improve oxidative stress indices in the serum and liver of STZ-induced diabetic rats. It is a potential therapeutic food supplement for the treatment and prevention of hyperglycemia and high oxidative stress of diabetes.
Avicenna Journal of Clinical Microbiology and Infection, Dec 29, 2018
Background: Although tuberculosis is a known disease, still on occasion, the tuberculosis patient... more Background: Although tuberculosis is a known disease, still on occasion, the tuberculosis patients remain undiagnosed and hence not treated appropriately. In some cases, the patient is not able to give a proper sputum sample. In some other cases, expert laboratory technician to examine the patient's sputum smear is not available. Furthermore, and in most cases of extrapulmonary tuberculosis, invasive diagnostic procedures such as biopsy might be followed. The aim of this study was to investigate the diagnostic value of serum level of adenosine deaminase (ADA) in extra pulmonary tuberculosis. Methods: In this analytical study, pulmonary tuberculosis patients were compared with two other groups of patients including lung cancer patients and healthy controls, based on national tuberculosis protocol. In each group, 40 patients who almost matched for age and sex were included. Blood samples were taken from the participants to measure serum ADA levels. Data were analyzed using SPSS software version 15.0. Results: Based on the data analyzed in this study, the mean ADA level in the patients with extra pulmonary tuberculosis was 23.8 IU/L which was significantly higher than that in the other groups (P < 0.001). Mean ADA levels in lung cancer patients and in healthy subjects were 15.8 IU/L and 10.7 IU/L, respectively. Conclusions: According to the results of this study, higher cutoff value for ADA would increase the specificity up to 100%. Moreover, serum ADA level can be a valuable additional index in diagnosis of extra pulmonary tuberculosis.
Archives of Medical Research, 2022
Background Tranilast is a potential NLRP3 inflammasome inhibitor that may relieve progressive inf... more Background Tranilast is a potential NLRP3 inflammasome inhibitor that may relieve progressive inflammation due to COVID-19. Aim of the study To evaluate the therapeutic effects of Tranilast in combination with antiviral drugs in non-ICU-admitted hospitalized patients with COVID-19. Methods This study was an open-label clinical trial that included 72 hospitals admitted patients with severe COVID-19 at Razi Hospital, Ahvaz, Iran, from July 2020–August 2020. These patients were randomly assigned in a 1:1 ratio to control (30) and intervention groups (30). Patients in the control group received antiviral therapy, while patients in the intervention group received Tranilast (300 mg daily) in addition to the antiviral drugs for Seven days. The collected data, including the expression of inflammatory cytokine, laboratory tests, and clinical findings, was used for intragroup comparisons. Results The intervention group showed significantly lower levels of NLR (p = 0.001), q-CRP (p = 0.002), IL-1 (p = 0.001), TNF (p = 0.001), and LDH (p = 0.046) in comparison with the control group. The effect of intervention was significant in increasing the o2 saturation (F = 7.72, p = 0.007). Long hospitalization (four days or above) was 36.6% in the Tranilast and 66.6% in the control group (RR = 0.58; 95% CI: 0.38–1.06, p = 0.045). In the Tranilst and control groups, one and four deaths or hospitalization in ICU were observed respectively (RR = 0.31; 95% CI: 0.03–2.88, p = 0.20). Conclusions Tranilast might be used as an effective and safe adjuvant therapy and enhance the antiviral therapy's efficacy for managing patients with COVID-19.
Journal of Parasitic Diseases, Jan 24, 2020
With sand flies as the main vectors, Leishmania species cause ancient zoonotic diseases called le... more With sand flies as the main vectors, Leishmania species cause ancient zoonotic diseases called leishmaniasis. Iran is an endemic country regarding cutaneous leishmaniasis. A number of 100 smear slides were collected from cutaneous lesions referred to Ahvaz health centers. The DNA was extracted and ITS1–PCR using LITSR and L5.8S primer pair was performed to detect the genus Leishmania. Then, enzymatic digestion of PCR products was done by HaeIII (species detection), TaqI (strain detection), DpnI and HpaII (mutation assessment). Furthermore, 50 samples were sent for sequencing. Microscopic examination showed amastigote form in all 100 slides. Also, molecular identification confirmed the infection of all cases to Leishmania genus, representing a 350 bp band. HaeIII digestion yielded 150 and 200 bp bands, indicating Leishmania major, while 130 and 200 bp fragments following TaqI digestion suggested A1 strain of the parasite. Moreover, no likely mutations was detected in ITS1 fragment of obtained parasites using DpnI (140 and 200 bp digestion) and HpaII (without digestion). The sequencing result also was consistent with our findings, having 100% homology to A1 strain sequence ({"type":"entrez-nucleotide","attrs":{"text":"AY550178","term_id":"45386258","term_text":"AY550178"}}AY550178). Leishmania major A1 strain was the predominant species in clinical samples of Ahvaz. Nevertheless, future researches should address the parasite strains in other foci and hosts of epidemiological significance.
Alexandria journal of medicine, Mar 1, 2017
Introduction: Leishmaniasis, as a major health concern exists in 14 out of 22 countries of the Ea... more Introduction: Leishmaniasis, as a major health concern exists in 14 out of 22 countries of the Eastern Mediterranean Region (EMR). Therefore, the aim of present investigation was to evaluate the epidemiological features and spatial distribution of cutaneous leishmaniasis (CL) during six consecutive years (2009-2014). Material and methods: In current retrospective cross-sectional study among 2009-2014, simple direct smear was taken from all suspicious CL subjects who referred to health centers affiliated to Ahvaz Jundishapur University of Medical Sciences. For each patient a questionnaire including some demographic details was filled. Eventually data analysis was done by SPSS.16. Results: Trend of CL in the region was unstable. Spatial distribution of CL in central and west cities was higher than in others. During the years, a total of 4137 smear positive individuals were diagnosed. Of these 55.7% lived in urban and 44.3% lived in rural districts. Frequency of CL was higher in men (60.1%) than in women (39.9%). Also based on age range, 11-30 was the most afflicted group (45.7%). Anatomic location of ulcers was as follows: hands 45.7%, feet 27.4%, face 19.1% and other places 7.8%. Conclusions: Regarding high incidence of CL in southwest of Iran, special programs related to vector and reservoir control should be adopted and implemented. Traffic control of immigrants and travelers from neighboring endemic countries, also can be helpful.
International Journal of Antimicrobial Agents, Jul 1, 2009
Objectives: Orthopedic implant infections are significant because of their morbidity, a tendency ... more Objectives: Orthopedic implant infections are significant because of their morbidity, a tendency to serious relapses and an elevated health cost. The aim of the present study was, to determine the bacteriology of orthopedic implant infections and susceptibilities of isolated bacteria to the commonly used antimicrobial agents. Methods: One hundred sixty five patients were investigated for early or late postoperative infections of orthopedic bone implants using conventional microbiological procedures. Antimicrobial susceptibility testing were then performed for the isolated bacteria according to the standard guideline. Results: A total of 155 isolates were recovered (152 aerobes and 3 anaerobes). Staphylococcus aureus, Klebsiella spp. and Pseudomonas aeruginosa were the most common causative agents: early (72.9%, less than 12 weeks), delayed (22.6%, between 3 to 24 months) and late (4.5%, after 24 months). About 72.9% of patients were with late; 22.6% with delayed and 4.5% with late infections. The majority of isolated bacteria were sensitive to vancomycin, ciprofloxacin and imipenem. Conclusion: Knowledge of the commonly isolated organisms and their antimicrobial susceptibility patterns within a given hospital assists in the selection of appropriate antimicrobial treatment.
Folia Phoniatrica Et Logopaedica, Jul 9, 2021
Introduction: Due to the upper and lower respiratory involvement in coronavirus disease 2019 (COV... more Introduction: Due to the upper and lower respiratory involvement in coronavirus disease 2019 (COVID-19), the voice quality of these patients is expected to be impaired. In this study, we aimed to conduct an auditory-perceptual evaluation of the vocal characteristics of patients with different severities of COVID-19. Methods: One hundred two patients with mild, moderate, or severe COVID-19 as well as 30 healthy individuals were recruited to compare their respiratory/phonatory parameters. The Persian version of the CAPE-V and GRBAS scales, along with the maximum phonation time and s/z ratio values were used to evaluate the severity of respiratory/phonatory disorders during verbal tasks in the participants. Results: Significant differences were found between the subgroups of patients and their healthy counterparts in all respiratory/phonatory parameters (p ≤ 0.03) except the s/z ratio (p = 0.81). Conclusions: Based on auditory-perceptual assessments, patients with COVID-19 showed dysphonia. The severity of dysphonia was significantly different among patients with different severities of COVID-19. Smoking can also play a significant role in vocal dysfunction in COVID-19 patients.
Nephrology Dialysis Transplantation, May 1, 2022
BACKGROUND AND AIMS: Allopurinol is the first-line prescribed agent for hyperuricemia and gout. A... more BACKGROUND AND AIMS: Allopurinol is the first-line prescribed agent for hyperuricemia and gout. Allopurinol-induced drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but serious and potentially life-threatening drug hypersensitivity syndrome. This study aimed to investigate the clinical features, treatment, outcome and prognostic factors of allopurinol-induced DRESS. METHOD: Case reports of allopurinol-induced DRESS published by China from January 2000 to August 2021 were retrieved from CNKI, Wan Fang, Wei Pu and PubMed databases for analysis. RESULTS: This study included 46 patients, consisting of 34 (73.9%) males and 12 (26.1%) females (M: F = 2.8:1). The mean of age was 56.1 ± 17.4 years (range: 23-86 years). The mean of latency periods was 24.0 ± 14.8 days (range:1-60 days). Most patients presented with fever, cutaneous eruption, eosinophilia, lymphadenopathy and facial oedema. All patients showed at least one internal organ injury. A total of 35/46 (76.1%) patients showed two or more internal organs involved. Liver and kidney injury were the most common visceral manifestations. One patient showed central nervous system involved, presenting as leukoencephalopathy. HLA*B 58:01 allele was tested in 19/46 (41.3%) patients. A total of 18/19 (94.7%) patients were positive. A total of 45/46 (97.8%) patients were treated with systemic corticosteroids. Patient outcomes were known for 45 of the 46 patients. A total of 13 (28.9%) patients were cured, 24 (53.3%) patients received partial recovery and 8 (17.8%) patients died. Septic shock and multiple organ failure were the leading causes of death. Patients with older age, underlying cardiovascular disease, chronic kidney disease, infection and internal organ involvement (including kidney, heart and lung) were associated with poorer outcomes. CONCLUSION: We explored clinical features, treatment, outcome and prognostic factors of 46 allopurinol-induced DRESS cases in China. Early identification and discontinuation of the causative drug are crucial to the management of DRESS. For patients with severe disease, corticosteroids are recommended as the first-line therapy. However, further studies are needed to address diagnostic criteria of DRESS for early diagnosis, as well as to develop standardized corticosteroid treatment regimens.
Iranian South Medical Journal, Sep 1, 2016
Background: Sulfur dioxide is one of the important pollutants that at the present time cause irre... more Background: Sulfur dioxide is one of the important pollutants that at the present time cause irreparable damage to environment and human health. The aim of present study was to study and comparison the effects of SO 2 on respiratory and cardiovascular deaths in Bushehr city. Materials and Methods: This analytical study was conducted in Bushehr city during 2011. In the first stage data were collected from Bushehr department of the environment. The concentration of SO 2 was measured by using BUBK portable device. After processing data by EXCEL software, data were converted as input file to the model and health effects of SO 2 pollutant were measured by using statistical analysis and the World Health Organization model (Air Q model). Results: The results showed that concentration of SO 2 pollutant with an annual average was 44 µg/m 3 in Bushehr city. In the study area, increasing the concentration of sulfur dioxide per 10 µg/m 3 than before values increased risk of cardiovascular death (0.8%) and respiratory deaths (1%). Conclusion: The local comparison results showed that the number of respiratory and cardiac cases death which is attributable to the sulfur dioxide pollutant has been low in Bushehr city health endpoint can result due to continued and this situation could be justified by the low concentration of sulfur dioxide in the air of Bushehr city.
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Papers by shokrollah salmanzadeh