International Journal of Infection

In Collaboration with Zahedan University of Medical Sciences

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The International Journal of Infection provides all infectious disease researchers from all over the world with a great opportunity to promote, share, and discuss various new issues and developments in different areas of infectious diseases via publishing their research results. The journal aims to present an academic platform for international physicians, medical scientists, allied health scientists, and public health workers, especially those from developing countries, on infectious diseases and tropical medicine.
The editors welcome original research articles, review articles, case reports, and clinical studies in all aspects of infectious diseases (natural history, pathology, pathogenesis, diagnosis, treatment, epidemiology, prevention, health promotion). We aim at publishing high-quality research in infectious diseases.

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Now showing 1 - 20 of 313
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    Persistent Isolation of Multidrug Resistant Gram-Negative Bacteria From Mechanically Ventilated Newborns in a Newly Established Neonatal Intensive Care Unit
    (Brieflands, 2017-04-30) Ujjwala N Gaikwad; Neeta Gade; Atul Jindal; Padma Das; Sanjay Singh Negi; Sarika Kombade; Anudita Bhargava
    Background: Ventilator-associated pneumonia is the second most common nosocomial infection in neonatal intensive care unit (NICU) patients. The recent trend signifies multidrug resistant (MDR) Acinetobacter baumannii and Pseudomonas aeruginosa as the most frequent causative agents in these cases. Objectives: The aim of this research was to study the trends in the isolation of MDR pathogens from a newly constructed NICU. Methods: A retrospective analysis of six months data on isolation of MDR pathogens from newborns on mechanical ventilation in a newly established NICU was done. Results: Out of seven, MDR Acinetobacter baumannii was isolated from four (57.14%) newborns on mechanical ventilation. The strain was sensitive only to polymyxin B and colistin and was isolated repeatedly from the initial three samples collected at an interval of two to three days. In one case, Pseudomonas aeruginosa was also isolated in association with Acinetobacter with same sensitivity pattern. While expecting recovery from illness in two babies, sudden change in the type of microbial flora was noticed in the samples collected on the 4th instance. This time, the initial polymyxin-sensitive organisms were replaced by intrinsically polymyxin resistant organisms like Serratia species and Burkholderia cepacia. Conclusions: Repeated isolation of MDR Acinetobacter baumannii along with other resistant phenotypes of gram-negative bacteria is a cause of concern for any newly established NICU setup. Long-term use of reserved antibiotics leads to selection pressure, resulting in establishment of the relatively less common environmental opportunists as new, more troublesome pathogens. It may further complicate the treatment decisions and lengthen the hospital stay and associated morbidity.
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    Cholera Outbreak in Yemen: A Regional or a Global Health Crisis?
    (Brieflands, 2018-04-30) Farzad Khademi; Arshid Yousefi-Avarvand; Hamid Vaez
    This article does not have an abstract.
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    Predictors of In-hospital Mortality Among COVID-19-infected Chronic Kidney Disease Patients on Maintenance Hemodialysis: A Retrospective Cohort Study
    (Brieflands, 2022-10-31) Ram Singh; Sudarsan Krishnasamy; Jitendra Kumar Meena; Prashant Sirohiya; Balbir Kumar; Brajesh Kumar Ratre; Saurabh Vig; Anuja Pandit; Hari Krishna Raju Sagiraju; Raghav Gupta; Sushma Bhatnagar
    Background: Patients with chronic kidney disease (CKD) on maintenance hemodialysis are highly vulnerable to coronavirus disease 2019 (COVID-19) infection and poorer outcomes and mortality. Objectives: The study aimed at identifying the various clinical and biochemical predictors of in-hospital mortality in this particular group of patients. Methods: In this retrospective cohort study, the baseline demographic, clinical, and laboratory data were collected from patients with preexisting CKD on maintenance hemodialysis and with COVID-19 infection. The statistical analysis of the collected data was performed using SPSS version 24 (SPSS Inc, Chicago, IL, USA). Results: The data obtained from 35 patients from the first wave of the pandemic were analyzed. The mortality rate was 23% (8 patients). Analyzing the comparison between survivors and non-survivors revealed that the older age (49 [IQR, 42 – 55] years vs. 70 [IQR, 54 – 74] years, P = 0.016), severe disease at presentation (15% vs. 75%, P = 0.004), and need for invasive mechanical ventilation (0% vs. 75%, P = 0.001) were the factors significantly associated with in-hospital mortality. Among baseline biochemical markers, severe lymphocytopenia (11 [IQR, 7 – 16] vs. 4.2 [IQR, 3 – 8], P = 0.011), high serum glutamic oxaloacetic transaminase (23 [IQR, 15.6 – 48] vs. 80 [IQR, 60- 105], P = 0.001), blood urea (71 [IQR, 28 - 120) vs. 160 (IQR, 142 - 355), P = 0.002) and higher value of inflammatory markers, interleukin-6 (IL-6), and procalcitonin, as well as fibrinogen and low baseline albumin, were also significantly associated with in-hospital mortality. Conclusions: The older age, severe disease at presentation, need for invasive mechanical ventilation, raised baseline IL-6, procalcitonin, serum glutamic oxaloacetic transaminase, blood urea, and lower level of albumin may have been valuable predictors of in-hospital mortality and poor outcomes in patients with COVID-19-infected chronic kidney disease on maintenance hemodialysis.
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    Evaluation of Thyroid Status in COVID-19 Patients: A Retrospective Study
    (Brieflands, 2022-10-31) Mehrangiz Zangeneh; Salar Javanshir; Rojin Sarallah; Yasamin Khosravani-Nezhad; Mirsaber Sadatamini; Manije Dezfulinejad; Yazdanali Faghani
    Background: Angiotensin-converting enzyme 2 (ACE2) is a receptor for SARS-CoV-2, expressed in many organs’ cells, including the thyroid gland. Therefore, COVID-19 may influence thyroid gland function. Objectives: In this article, we aimed to investigate the thyroid gland function in COVID-19 patients and compare them to healthy society to indicate whether thyroid hormones level differ in the disease or not. Methods: This is a single-center retrospective case-control, cross-sectional study on 191 COVID-19 patients and 179 non-COVID-19 individuals as the control group. The status of the thyroid hormones was determined in COVID-19 patients and then compared with the control group. Patients in the case group were divided into 2 groups with and without normal thyroid function and were compared with each other in different aspects of COVID-19. Also, we compared thyroid hormone levels in the patient group with different underlying diseases to show the status of thyroid function in COVID-19 infection. Results: Of the 191 COVID-19 patients, 98 (51.3%) were male, and the mean age of patients was 64 ± 15 years. The thyrotropin level was lower in the patient group than in the control group (1.34 ± 1.29 vs. 2.21 ± 1.99; P < 0.001). The T3 status was meaningfully associated with the level of SpO2 (P < 0.05; r = -0.258). The results demonstrated that thyrotropin (P = 0.653), T3 (P = 0.404), and T4 (P = 0.147) levels were not different in expired and discharged patients. The 2 groups of patients with and without normal thyrotropin levels did not appear significantly different in any aspect of the disease. Conclusions: Thyrotropin level was lower in COVID-19 patients, and the T3 level can predict the SpO2 level. The thyroid gland may be theoretically affected by SARS-CoV-2 infection.
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    Effects of Interferon β1-a Administration in the First Versus Second Week of Treatment on Recovery in Patients with COVID-19: A Retrospective Study
    (Brieflands, 2022-04-10) HamidReza Samimagham; Mehdi Hassani Azad; Mohsen Arabi; Sara Ghazizadeh; Alireza Malektojjari; Golbahar Ghasemi; Mitra Kazemi Jahromi
    Background: COVID-19, an acute respiratory disease caused and transmitted by SARS-COV-2 virus, has turned into a major global concern since 2019. In severe cases, the elevated levels of immune cells cause inappropriate responses. To date, no medications have been approved for COVID-19. Methods: The present retrospective cohort study was designed and conducted in Shahid Mohammadi Hospital, Bandar Abbas, Iran, in 2020. Eligible patients with confirmed COVID-19 based on PCR test were included (n = 200) and allocated to two groups to receive interferon β1-a (IFNβ1-a) either in the first or in the second week of treatment (IFN week 1 and IFN week 2 groups, respectively). The primary objective of this study was to compare the effectiveness of IFNβ1-a administration in the first and the second week of treatment on patient mortality. The secondary objective was to investigate the difference between the two groups in terms of laboratory data and length of hospitalization. The data were analyzed using Chi-square and Fisher’s exact tests. Results: The study population was divided into two equal groups. IFNw1 group received IFNβ1-a in the first week and IFNw2 group in the second week of treatment. The two groups matched in terms of baseline demographic data. The mortality rate was significantly lower in the IFNw1 group (13% vs. 18%; P-value = 0.01). At discharge, C-reactive protein (CRP) was clearly reduced in the IFNw1 group compared to the IFNw2 group (15 ± 12 vs. 24 ± 16; P-value = 0.02), but other lab variables did not show a significant difference between the two groups. Conclusions: There was a relationship between IFNβ1-a administration time and the trend of recovery in patients with moderate COVID-19. Administration of IFNβ1-a in the first days of treatment can reduce inflammatory factors and mortality rates in these patients.
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    Comorbidities, Infections, and Mortalities of COVID-19 in Bangladesh During May-June 2021
    (Brieflands, 2022-04-30) Ahasan Ullah Khan; Rumana Akter; Foyj Ullah Khan; Shakhera Khanom; Bidyut Das; Anayat Ullah Khan; Ayesha Shiddika Afsana
    Background: COVID-19 is the serious ruin of the current century that emaciated health, economy, and everyday life. Objectives: This research assessed the condition and relation of tests, infections, recoveries, and deaths of SARS-CoV-2 from May 1 to June 30, 2021. Methods: The research plan was carried out from May 1 to June 30, 2021 (N = 61 days) to state the position of Bangladesh towards widespread COVID-19. The information in this study was obtained from different government organizations. Results: The total cases, infections, recoveries, and deaths were 1100361, 149576, 136159, and 2864, respectively, during the study period. In May 2021, the total number of COVID-19 tests, infections, recoveries, and deaths was 439111, 36858, 49147, and 975, respectively. In June 2021, the total number of COVID-19 tests, infections, recoveries, and deaths was 661250, 112718, 87012, and 1889, respectively. The maximum number of COVID-19 infections was 1914 on May 4, recoveries 3870 on May 4, and deaths 69 on May 2. The minimum number of COVID-19 infections was 261 on May 15, recoveries 601 on May 16, and deaths 17 on May 26. The maximum number of COVID-19 infections was 8822, and recoveries were 4550 on June 30, while deaths were 119 on June 27. The minimum number of COVID-19 infections was 1447, and recoveries were 1667 on June 5, while deaths were 30 on June 3 and 7. In May and June, a positive correlation was observed between the tests and infections, recoveries, and deaths, and a negative relationship was found between a date with daily tests of COVID-19 (R2 = 0.8359, 0.2147, 0.1424, and 0.0035 and R2 = 0.6016, 1, 1, and 0.6488). At the 0.01 level of two-tailed Spearman, the relationships were positive and moderate to strong. The Spearman relationship for infections, recoveries, and deaths was 0.606, 0.756, 0.689, and 0.736. This research additionally showed a moderate to strong relationship between tests, infections, recoveries, and deaths of SARS-CoV-2. Conclusions: COVID-19 has spread rapidly to 64 districts in Bangladesh. The continuing occurrence of COVID-19 infections has emphasized the importance of the quick and developed 118 laboratory diagnoses to limit its spread. In this situation, people should avoid public gatherings as much as possible and return home as soon as possible after finishing work.
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    Antibiotic Resistance Pattern of Urinary Tract Infections Among Patients with Recent Antibiotic Use: A Cross-sectional Study
    (Brieflands, 2023-01-31) Behzad Yousefi Yeganeh; Golnaz Mahmoudvand; Reza Nejad Shahrokh Abadi; Majid Heidarian; Arian Karimi Rouzbahani
    Background: With the increasing rate of bacterial resistance and the emergence of multidrug-resistant pathogens, urinary tract infections (UTIs) are now among the most important public health problems worldwide. Objectives: This study aimed to investigate the antibiotic resistance patterns of UTIs in Shahid Rahimi and Shohada-ye Ashayer hospitals of Khorramabad, Iran, in 2021. Methods: In this cross-sectional study, 250 patients with UTI were included. Demographic characteristics and data related to the pathogen types and antibiogram were collected from their medical files and recorded in a researcher-made checklist. The collected data were analyzed by Stata software version 14 at a 5% significance level. Results: The study population consisted of 163 women (65.2%) with a mean age of 54.52 ± 10.12 and 87 men (34.8%) with a mean age of 51.87 ± 12.01. The most common pathogens reported were Escherichia coli (41.20%), followed by Staphylococcus saprophyticus (20.80%), and Klebsiella pneumonia (18.40%). The most frequently reported resistances were against Amoxicillin (59.2%), followed by Ampicillin (53.6%), while the least reported were Imipenem (11.6%), followed by Amikacin (17.6%). Conclusions: A high rate of resistance was observed against the commonly used antibiotics. It is crucial to prescribe antibiotics, particularly those with relatively low resistance rates (such as imipenem and amikacin), cautiously to prevent bacterial resistance against antimicrobial agents.
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    Prevalence of Intestinal Parasitic Infection and Associated Risk Factors Among Primary School-Aged Children (5 - 15 years) in Southern Nigeria
    (Brieflands, 2022-07-31) Joan Gbonhinbor; Austin E Abah; Grace Awi-Waadu
    Background: In Nigeria, intestinal parasitic infection (IPI) is one of the neglected tropical diseases of public health importance. Objectives: This study investigated intestinal parasitic infection and associated risk factors among primary school-aged children in Sagbama Local Government Area, Bayelsa State, Nigeria. Methods: A total of 622 stool samples (335 males and 287 females) were collected from 13 primary schools in nine communities and analyzed using parasitological techniques (direct wet mount and formal ether concentration method). The Tukey Honest Significance Difference test (HSD) was used to determine the association and variation between prevalence and socioeconomic variables. Results: Nine parasite species were encountered with a total prevalence of 23.95%, including Ascaris lumbricoides (7.32%), Entamoeba histolytica (4.98%), Strongyloides stercorals (2.09%), Giardia lamblia (1.93%), Hookworm (1.77%), Trichuris trichiura (1.61%), Schistosoma mansoni (1.45%), Diphyllobotium latium (0.64%) and Fasciola hepatica (0.32%). A total of 4.50% of infections were mixed. With 30.26%, the age group 5 - 7 years had the highest infection rate. The second most prevalent age group was 8 - 10 years old (26.53%), while the least prevalent age group was 14 - 16 years old (12.60%). Males were more infected with the disease, 25.07%, than females, 22.65%. Ascaris lumbricoides were the most predominant parasites encountered across the nine communities. There was a significant difference between the infected population in the nine communities at P < 0.05 (P = 0.001). Conclusions: There was a relatively high prevalence of intestinal parasitic infection among primary school children in Sagbama local government area. Improved sanitation, safe drinking water, and a step-up in health education in the communities will reduce the exacerbation of the infection in the area.
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    Investigation of the Microbial Contamination of the Hands of Healthcare Workers in Different Wards of Sheikh Hospital in Mashhad
    (Brieflands, 2022-07-31) Zoleikha Avestan; Mohammad Jami; Marziyeh Mirzaei; Yousef Amini; Kiarash Ghazvini; Hadi Safdari; Aida Gholobi; Hadi Farsiani
    Background: Many nosocomial infections, which cause death and cost society, may be transmitted through healthcare workers’ contacts. Preventive health measures greatly reduce their prevalence. Objectives: This study aimed to investigate the microbial contamination of healthcare workers’ hands in different wards of Sheikh Hospital. In addition, the alcohol-based hand sanitizers’ ability to reduce microbial load of nosocomial infections was evaluated. Methods: The present study was performed in spring 2019. Thirty-two nurses’ hand samples were obtained from different wards of the hospital, including emergency, ICU, surgery, peritoneal dialysis, nephrology, and hematology-oncology. Biochemical tests determined the isolates. Participants’ hands were cleaned using a standard procedure using soap and 70% isopropyl alcohol-based hand sanitizer. Results: Different species, including coagulase-negative Staphylococcus (CoNS), Klebsiella pneumoniae, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus, Klebsiella oxytoca, Acinetobacter baumannii, Stenotrophomonas maltophilia, and Burkholderia cepacia complex were isolated. Following hand hygiene procedure, the most effective decontamination for a wide variety of organisms was observed. Conclusion: Separation of dangerous pathogenic bacteria such as S. aureus, K. pneumoniae, and E. coli from healthcare workers may be a great warning sign for these infections in the hospital. Therefore, hand hygiene procedures may be considered an appropriate method to decrease nosocomial infections.
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    Comparison of Cesarean Surgical Site Infection in Patients Treated with Cefazolin and Cefazolin-Azithromycin Regimes: A Quasi-experimental Study in a Developing Country
    (Brieflands, 2022-01-31) Mahtab Mosadegh; Narges Noori; Marzieh Ghasemi
    Background: Prophylactic antibiotics effectively reduce the incidence of infection associated with cesarean section after labor. The use of a first-generation cephalosporin for antibiotic prophylaxis has been suggested in these patients, but in some studies, increasing the spectrum of antibiotic prophylaxis by adding another antibiotic to standard cephalosporin may provide greater protection against post-cesarean wound infections. Objectives: The present study aimed to compare the effects of conventional prophylaxis with cefazolin with a combination of cefazolin and azithromycin in reducing wound infection. Methods: In this quasi-experimental study, 200 cesarean section candidates admitted to Ali Ibn Abi Taleb Hospital in Zahedan, Iran, in 2019 - 2020 were divided into two groups of 100 patients. The control group received cefazolin alone, and the intervention group received cefazolin and azithromycin. Finally, in addition to demographic factors, various underlying diseases, causes of cesarean section, non-infectious wound complications, and post-surgery wound infection were investigated. Results: The two groups were homogenized in terms of age and BMI of patients. Surgical wound infection occurred after cesarean section in 3% of patients in the control group. Only 1% of infections were observed in patients in the intervention group, and the two groups had a statistically significant difference (P = 0.01). Conclusions: Compared with cefazolin alone, the combination of cefazolin and azithromycin was more effective in preventing cesarean section wound infection. Therefore, the combined use of these two antibiotics instead of cefazolin alone is recommended for this desirable clinical outcome.
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    The Association Between Physical Activity Level of CVD Patients and Rate of Covid-19 Incidence
    (Brieflands, 2022-04-30) Rastegar Hoseini; Zahra Hoseini; Elahe Bahmani; Mahsa Ahmadi Darmian
    Background: Decreased physical activity level (PAL) and consequent lifestyle alterations might induce cardiovascular diseases (CVDs). Like many other chronic diseases, CVD attenuates the immune system, which in turn can affect the rate of COVID-19 infection and its severity. Objectives: This study aims to investigate the association between PAL and the rate of COVID-19 incidence in CVD patients. Methods: The statistical population of this descriptive cross-sectional study included all CVD patients in Kermanshah, among which 727 individuals (371 men and 356 women) were randomly selected as the statistical sample. The International Physical Activity Questionnaire (IPAQ-SF) was used to assess the PAL. The independent t-test was used to compare men and women. Also, the association between variables was evaluated by the Pearson correlation coefficient test (using SPSS 24 at the significance level of P < 0.05). Results: No significant differences were observed in the PAL and the incidence of COVID-19 between men and women. There is also a significant positive association between low and severe PAL and the incidence of COVID-19 in men and women suffering from CVD. However, there was a significant inverse association between moderate PAL and the incidence of COVID-19. Conclusions: This study demonstrated that moderate PAL might prevent or reduce the severity of COVID-19 in CVD patients by strengthening the immune system.
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    The Need for Pre-vaccination Screening
    (Brieflands, 2022-04-30) Mostafa Mohammadi; Alireza Khafaee Pour Khamseh; Hesam Aldin Varpaei
    This article does not have an abstract.
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    Prevalence of Intestinal Parasitic Infections in Relation to the HIV Status of Patients Attending the Care Units in Three Divisions in the Centre Region of Cameroon
    (Brieflands, 2019-04-30) Stephanie Jupsa Mbiandou; Samuel Fosso; Edimo Bille; Armand Beleck Matoh; Hugues Nana Djeunga; Albert Same Ekobo; Flobert Njiokou
    Background: Depression of the immune system caused by the human immunodeficiency virus (HIV) promotes the onset of opportunistic infections including intestinal parasites. Objectives: In this study, we are comparing the prevalence of these parasitic infections among individuals infected with HIV (HIV+) and non-infected (HIV-) enrolled in four HIV care units in the Centre Region of Cameroon. Methods: A cross-sectional study was conducted and stool samples were collected from 283 HIV positive subjects and 245 seronegative subjects. These samples were processed using direct wet mount, formol-ether concentration, Kato-Katz procedure, modified Ziehl-Neelsen staining, and Baermann techniques to identify both common and opportunistic intestinal parasites. Logistic regression analyses were used to assess the association between HIV infection and socio-demographics factors as well as infection with intestinal parasites. Results: A total of 123 (23.4%) individuals were found infected with at least one protozoan parasite species, and nine (1.7%) with intestinal worms. Overall, infection rates were 27.9% and 22.4% among HIV+ and HIV- subjects, respectively. The frequencies of Cryptosporidium spp. and Entamoeba histolytica/dispar were significantly more important among HIV+ subjects (P < 0.0455). Pentatrichomonas hominis and Entamoeba coli were significantly more prevalent among HIV- subjects (P < 0.0210). Heterogeneity was observed in the distribution of intestinal parasites, according to socio-demographic parameters. In addition, Cryptosporidium spp. was significantly associated with the decrease in CD4 cell count (P = 0.0035). The frequencies of infections with Cryptosporidium spp., Isospora belli, and Iodamoeba buetschlii were significantly more important in HIV positive patients not taking antiretroviral (P < 0.0226). Conclusions: Cryptosporidium spp., Entamoeba histolytica/dispar, and Blastocystis spp. were the intestinal pathogens more often found among HIV infected individuals. HIV positive subjects were significantly more infected with intestinal parasites than seronegatives in intermediate and rural settings, among individuals aged more than 45 years and among unemployed individuals.
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    Prevalence of Methicillin-Resistant Staphylococcus aureus in Hospitals and Community in Duhok, Kurdistan Region of Iraq
    (Brieflands, 2019-07-09) Nawfal Hussein; Reving S Salih; Narin A Rasheed
    Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a serious concern of the global health sector and more recently, an escalating problem in the community. Objectives: This study was performed to investigate the incidence of MRSA in hospital staff and community students in Duhok, Kurdistan, Iraq, and make a molecular comparison between the strains based on the detection of mecA gene and Panton-Valentine Leukocidin (PVL) gene. Methods: We obtained 109 and 103 samples from the nares of hospital staff and community students, respectively. Conventional laboratory tests were performed for the detection of Staphylococcus aureus (S. aureus) and antibiotic sensitivity testing to identify MRSA isolates. Besides, PCR was utilized for molecular analysis. Results: All isolates from hospital staff were identified as S. aureus. Out of the 109 isolates, 55 (50.4%) were MRSA carrying the mecA gene, among which 4/55 (3.7%) were MRSA-PVL positive. Additionally, 54/109 (49.5%) isolates were methicillin-sensitive S. aureus (MSSA) but four isolates (3.7%) were MSSA-PVL positive. Furthermore, 23/103 (22.3%) samples from community students were identified as S. aureus, among which 5/23 (21.7%) and 17/23 (73.9%) isolates were MSSA-PVL positive and MSSA-PVL negative, respectively. Moreover, 1/23 (4.3%) was found as MRSA and was PVL gene-positive. Conclusions: The results showed that MRSA is swarming in hospitals and community in Duhok, Iraq. The highest rate of PVL was associated with community-acquired-MSSA (CA- MRSA). With further genotypic study, immediate action is needed to control and reduce the spread of MRSA clones, determine their clonal relations, and conduct epidemiological investigations.
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    Evaluation of Factors Related to Survival Time in HIV-Infected Persons in Mashhad, Iran, Between 1994 - 2014: A Bayesian Joint Model
    (Brieflands, 2019-08-24) Niloofar Shabani; Habibollah Esmaily; Rasul Alimi; Abdolhamid Rezaei Roknabadi
    Background: The prevalence of HIV is increasing in Iran, so obtaining an estimate of the survival of HIV-infected persons can be helpful to prevent and control this infection. Objectives: This research aimed to use the Bayesian joint model by which identifies factors associated with the survival and determine the relationship between the trend of CD4+ T cell counts and survival time in HIV-infected persons. Methods: In this retrospective cohort study, we collected HIV/AIDS surveillance data from Mashhad’s Counseling Center of Behavioral Diseases in the province of Khorasan Razavi, Northeast of Iran, during 1994 - 2014. Data collection included variables CD4+ T cells count, survival time, and other related factors. We used the Bayesian joint model to estimate the survival time and identify the factors associated with survival time in HIV-infected persons. Results: The study included 260 individuals, of whom 212 (81.54%) were male. The survival sub-model of the joint model identified gender (95% credible interval (CI): 0.486, 3.197) and antiretroviral treatment (95% CI: -1.935, -0.641) as the variables associated with the patients’ survival. The longitudinal sub-model, which determined the variables associated with the number of CD4+ T-cells included time (95% CI: -0.934, -0.554), age (95% CI: -0.152, -0.011), and antiretroviral treatment (95% CI: -6.193, -3.505). Conclusions: Using CD4+ T cells as a covariate in the Bayesian joint model, the survival time for HIV-infected persons was estimated more precisely than separate model and it can be inferred that at the beginning of antiretroviral treatment, especially in men and controls, the CD4+ T cell counts can increase the survival time of HIV-infected persons.
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    Frequency of Viral Transfusion-Transmitted Infections (TTIs) Among Resident and Pilgrim Blood Donors in Mashhad, 2011
    (Brieflands, 2019-04-30) Mohammad Reza Hedayati-Moghaddam; Farzad Mollahosseini Foomani; Arezoo Gowhari Shabgah
    Background: Mashhad is a large pilgrimage city with over 20 million pilgrims and tourists annually. Some pilgrims donate their blood voluntarily during the pilgrimage. Objectives: The present study aimed to compare the prevalence of viral transfusion-transmitted infections (TTIs) between resident and pilgrim blood donors in Mashhad. Methods: We reviewed the records of all blood donors in Mashhad blood centers in 2011. The demographic data and the prevalence of TTIs, including HBV, HCV, HIV, and HTLV-1, were compared between 42821 donors from Mashhad and 15219 donors from other cities of Iran. The data were analyzed using Microsoft Excel 2010 and Epi-Info 6.0 software. Results: The mean age of residents and pilgrims was 34.6 ± 9.9 and 34.2 ± 10 years, respectively. The male to female ratio in the first group was higher than that in the second group (13.1 and 6.6, respectively). One-third of the residents and nearly two-thirds of the pilgrims were first-time blood donors. The most prevalent TTIs among the residents were HTLV-1 (0.39%) and HBV (0.33%); however, the frequencies of these infections were 0.24% and 0.57% among the pilgrims, respectively. The seroprevalence of HCV infection was 0.054% and 0.072% in the first and second groups, respectively. The HIV infection was observed only in one donor from Mashhad. Conclusions: A low prevalence of TTIs, particularly HCV and HIV infections, was found among blood donors from all parts of Iran. A higher prevalence of HTLV-1 infection among Mashhad donor population than among donors from other parts of Iran verified the virus endemicity in this region.
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    Acute and Massive Aortic Thrombosis and Embolic Occlusion in a Patient with COVID-19: A Case Report
    (Brieflands, 2021-10-31) Seyedjavad Davarisani; Javad Koushki; Saeed Moghaddamzade; Hamzeh Sherafati; Mehdi Jamalinik; Ali Abedi; Fatemeh Salaripour; Maryam Sarkardeh
    A 73-year-old man with a history of COVID-19 infection from two weeks ago was referred to the Emergency Department with a complaint of colicky and generalized abdominal pain in addition to prior respiratory symptoms. High-resolution Computed Tomography (HRCT) displayed the typical signs of COVID-19 pneumonia. Initially, laboratory tests showed increased C-reactive protein and severe leukocytosis. Because of generalized abdominal pain, spiral abdominal and pelvic CT scans were done, which showed massive irregular and free-floating aortic thrombosis from the carina site to the Superior Mesenteric Artery (SMA) detachment, indicative of acute and life-threatening thrombosis. Filling defects were seen in the middle and distal part of the splenic artery, indicating the embolic occlusion of the splenic artery. The patient was admitted to the Intensive Care Unit (ICU), and he became a candidate for conservative treatment because of the wide extension of thrombosis. Therefore, we should pay more attention to the indirect signs of thrombosis in patients with COVID-19 infection with gastrointestinal symptoms and consider anticoagulant therapy for high-risk patients with COVID-19. The unique feature of our case was acute and extensive arterial thrombosis.
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    An Overview of Complications and Mortality of Crimean-Congo Hemorrhagic Fever
    (Brieflands, 2019-04-30) Hamidreza Kouhpayeh
    Context: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne acute viral hemorrhagic fever with variable complications and mortality. Its mortality rate could be as high as 60% - 80% or as low as 0% - 5%. The most common complications are hemorrhage, shock, DIC, and multi-organ failure that might result in death. Evidence Acquisition: This review was conducted based on 18 articles, two text books, and the experience gained by the author on CCHF cases since 1999. The articles were taken from different sources, specially Google Scholar. Three of the articles were published by the author and his colleagues. Different sections of the reviewed articles including results, conclusion, and discussion were used for this overview. Results: The most common complication of CCHF in different studies has been hematologic disorders of which, thrombocytopenia and increased PTT and PT time are the most common disorders seen in up to 100% of CCHF patients. Bleeding in different organs, especially the oral cavity, is the next common complication. The average mortality rate is 10% to 40%, but it might vary from as low as 0-5% in Iran to as high as 60% - 80% in different regions. The usual causes of death are shock, DIC, and multi-organ failure including hepatic, renal, and respiratory failure. Moreover, rare complications such as intracerebral hemorrhage, compartment syndrome, intra-abdominal, pleural and pericardial effusions, acute pancreatitis, myocarditis, and cholecystitis are reported. Conclusions: CCHF has many common and rare complications some of which may lead to death. The most important causes of mortality are hemorrhage, shock, and multi-organ failure, but the mortality rate is very different and is related to the experience of the treatment center in early diagnosis and treatment of the disease and its fatal complications. Moreover, there are other less common or rare complications of CCHF that may be difficult to be diagnosed and managed by inexperienced physicians.
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    Coronavirus and Public Health Lessons
    (Brieflands, 2021-10-31) Saeed Hamzehie; Pooyan Afzali Harsini
    This article does not have an abstract.
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    Retraction Note: Isolation of Lactobacillus Species from Domestic Dairy Products of Mahabad City
    (Brieflands, 2019-08-11) Masoud Salehi
    This article does not have an abstract.