This report presents two cases of invasive rhino-orbital mucormycosis who had life-threatening reactions to amphotericin B. Both cases were treated with a combination of posaconazole–caspofungin favorably with no evidence of recurrence upon long-term follow-up. To our knowledge, this is the first report of successful treatment of invasive mucormycosis with azole–echinocandin combination. It may suggest that caspofungin exerts additional or even synergistic antimucoral effects to posaconazole.
Introduction Seasonal influenza is a significant public health challenge worldwide. This study aimed to investigate the epidemiological characteristics and spatial patterns of severe hospitalized influenza cases confirmed by polymerase chain reaction (PCR) in Iran. Methods Data were obtained from Iran’s Ministry of Health and Medical Education and included all hospitalized lab-confirmed influenza cases from January 1, 2016, to December 30, 2018 (n = 9146). The Getis-Ord Gi* and Local Moran’s I statistics were used to explore the hotspot areas and spatial cluster/outlier patterns of influenza. We also built a multivariable logistic regression model to identify covariates associated with patients’ mortality. Results Cumulative incidence and mortality rate were estimated at 11.44 and 0.49 (per 100,000), respectively, and case fatality rate was estimated at 4.35%. The patients’ median age was 40 (interquartile range: 22–63), and 55.5% (n = 5073) were female. The hotspot and cluster analyses revealed high-risk areas in northern parts of Iran, especially in cold, humid, and densely populated areas. Moreover, influenza hotspots were more common during the colder months of the year, especially in high-elevated regions. Mortality was significantly associated with older age (adjusted odds ratio [aOR]: 1.01, 95% confidence interval [CI]: 1.01–1.02), infection with virus type-A (aOR: 1.64, 95% CI: 1.27–2.15), male sex (aOR: 1.77, 95% CI: 1.44–2.18), cardiovascular disease (aOR: 1.71, 95% CI: 1.33–2.20), chronic obstructive pulmonary disease (aOR: 1.82, 95% CI: 1.40–2.34), malignancy (aOR: 4.77, 95% CI: 2.87–7.62), and grade-II obesity (aOR: 2.11, 95% CI: 1.09–3.74). Conclusions We characterized the spatial and epidemiological heterogeneities of severe hospitalized influenza cases confirmed by PCR in Iran. Detecting influenza hotspot clusters could inform prioritization and geographic specificity of influenza prevention, testing, and mitigation resource management, including vaccination planning in Iran.
Background and aim: The main challenging issue about coronavirus disease 2019 (COVID-19) is the production of safe and stable vaccines, which is a very long process. Due to the emergency situation, regular and extensive screening of available and traditional drugs, which are commonly used for the treatment of similar viral diseases, can be a reasonable option. The present study aimed to compare the administration of hydroxychloroquine (HCQ) plus arbidol to the use of HCQ alone in the treatment of COVID-19 infection. Methods and Materials: This single-blind randomized controlled trial was carried out on a total of 100 patients with COVID-19 referring to the infection ward of Imam Reza Hospital in Mashhad, Iran, in 2020. The patients were randomly assigned to two HCQ alone and HCQ plus arbidol groups. Results: According to the obtained results, hematological parameters, including white blood cell count, hemoglobin level, lymphocyte count, and platelet count, improved in patients with COVID-19 after the treatment with both HCQ plus arbidol and HCQ alone (P<0.005). The mean values of the reduction time of C-reactive protein (CRP) were4.48±1.24 and 8.22±2.08 days in the arbidol and HCQ alone groups, respectively, indicating that CRP decreased faster in the arbidol group than that reported for the HCQ alone group (Z=0.-7.85; P<0.000).The mean scores of hospital stay were reported as 5.89±2.04 and 9.35±3.72 days in the arbidol and HCQ alone groups, respectively (Z=-4.31; P<0.005). All the patients in the arbidol group survived; while 6% of the subjects in the HCQ alone group died. In addition, the drug regimen was not changed for any patient, and no subject was transferred to the intensive care unit in the arbidol group. Conclusion: In summary, the administration of both arbidol and HCQ leads to the improvement of the hematological parameters. The present study introduced arbidol as an effective treatment for moderate to severe patients with COVID-19, which not only reduced the time of CRP normalization level but also decreased the hospitalization duration and mortality compared to those reported for HCQ.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.