This study aimed to investigate the clinical and epidemiologic features of Crimean-Congo hemorrhagic fever among 34 children and adolescents (mean age, 13.3 +/- 4.6 years) from a highly endemic region. Clinical manifestations were similar to those in adults. The case-fatality ratio was 26.5% (9 of 34). Compared with adult patients, children and adolescents may be more vulnerable to severe and fatal Crimean-Congo hemorrhagic fever.

No abstract

Background:Crimean-Congo hemorrhagic fever (CCHF), an acute viral infection, is a zoonotic disease which is transmitted to humans by infected ticks, direct contact with fresh meat or blood of infected animals (usually domestic livestock), or direct contact with the blood or secretions of an infected person. Livestock handlers, skin processors, veterinary staff, livestock market workers, and other personnel engaged in jobs requiring some contact with animals and/or animal products are at high risk for CCHF. Most reported cases of this disease in Iran belong to butchers and slaughterhouse workers.Objectives:We aimed to study the prevalence of CCHF in slaughterhouse workers and livestock handlers who were admitted to Boo-ali Hospital for treatment of CCHF.Materials and Methods:We evaluated all patients’ files with confirmed CCHF admitted to Boo-ali Hospital in Zahedan, in southeastern part of Iran, during 1999-2011. Then, we examined the prevalence of disease among the high risk groups.Results:Out of 362 patients with CCHF (86% male, 14% female; with age range 12-78 years), 123 (34%) were slaughterhouse workers, 103 (28.5%) livestock handlers and farmers, 32 (9%) housewives, 7 (2%) students, 6 (1.9%) teachers, 4 (1.2%) military personnel, and other groups were workers with different employments.Conclusions:The present study showed that CCHF is highly prevalent in high risk occupational groups in Zahedan, Iran. Further surveillance, teaching and prevention programs are recommended.

BackgroundThe association between smoking and tuberculosis (TB), which has been proven in multiple studies with different study population ethnicity, has not yet received sufficient attention in terms of TB control.ObjectivesThe aim of the present study was to determine the association between TB and cigarette smoking in southeastern Iran, an endemic area for tuberculosis.Patients and MethodsThis prospective case-control study conducted at a University-Affiliated Hospital (Boo-Ali Hospital, Zahedan, and Southeastern Iran) from March 2007 to March 2012 enrolled 253 TB patients and 312 healthy controls. Factors including history of cigarette smoking, duration of smoking, number of cigarettes smoked per day, consumption of other drugs (parenteral and non-parenteral), and family history of tuberculosis and smoking, were evaluated in both cases and controls. Univarate and multivariate logistic regressions were performed to compare TB cases and controls. The odds ratio (OR) and 95% confidence intervals (CI) were also estimated.ResultsThe results of the study revealed a significant difference between TB and control groups in relation to smoking (P < 0.0001). In multivariate logistic regression, cigarette smokers were 3.1 (95% CI: 1.4-10.3) times more frequent in TB patients compared with controls. Other factors that showed significant differences between TB patients and controls were the use of non-parenteral drugs (OR = 3.6, 95% CI: 2.2-21.4), family history of TB (OR = 6.6, 95% CI: 2.3-18.2), family history of smoking (OR = 2.8, 95% CI: 1.1-8.4), and smoking history of more than 10 years (OR = 1.6, 95% CI: 1.2-9.8).ConclusionsThe present study evidenced the association between TB and smoking. It is therefore recommended to include interventions for smoking cessation in the current TB control practice.

Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P < 0.001). No one in the intervention group died. It seems that high-dose methylprednisolone is effective in the treatment of patients with CCHF. The increased platelet count and reduction of blood product requirement for severe CCHF patients after receiving HDMP are promising results. Further investigation is necessary in order to determine the efficacy of corticosteroid and its effect on outcome.

BackgroundIL-10 can play a vital role in immune response against HBV. Three biallelic SNPs from the transcription start site control the transcription of the IL-10 gene. An association between susceptibility to HBV and IL-10 polymorphisms has been suggested in patients with HBV infection.ObjectivesThe present study was designed to study the association between polymorphisms in interleukin-10 (-1082 A/G, -819 T/C and -592 A/C) promoter gene and chronic hepatitis B virus (HBV) infection.Patients and Methods221 chronically infected patients and 200 healthy control subjects were enrolled in the study. Three biallelic (-1082 A/G, -819 T/C and -592 A/C) polymorphisms in the IL-10 promoter gene were determined by PCR-RFLP method.ResultsPersistent HBV infection was associated with IL-10-1082 AG (P = 0.001) and GG (P = 0.004) genotypes and G (P = 0.000) allele. IL-10-819 T/C and -592 A/C genotype and allele frequencies did not show any correlation with the risk of chronic hepatitis B infection.ConclusionsThese results suggest that polymorphisms in interleukin-10 gene promoter influence clinical outcome of HBV infection and susceptibility to HBV infection.

It is shown that the electroweak physics of the electron and the muon is based on the left-right gauge model with the mixing parameters 0.2254 and 0.2746. These mixing parameters are determined by the masses of the electron and the muon. The electroweak physics of the Tau-lepton and its left-handed neutrino is based on the gauge group SU(2)LXU(1).The mixing parameter for this gauge model is 0.5 and is determined by the mass of the charged Tau-lepton. The W and Z bosons that mediate the electroweak physics of Tau-lepton and its neutrino have masses 173.5 GeV and 245.4 GeV, respectively.

Context:Cholera is an intestinal infection caused by Vibrio cholera and transmitted by the fecal-oral route. The source of V. cholerae in nature is human and the most common vehicle of this infection is water and infected food. Here, we reviewed diagnosis, treatment, and prevention routes of cholera. Evidence Acquisition: Electronic databases (PubMed and EMBASE) were searched from 1980 to 2013 regarding epidemiology, treatment, and prevention routes of cholera. Keywords including cholera, epidemiology, clinical manifestation, and treatment of cholera, and control and prevention routes were searched. In this review article, we focused mainly on the treatment and control of cholera. Results: Cholera is a rare disease in industrialized countries; but, is still common in other parts of the world, including the Indian subcontinent, Sub-Saharan Africa, and Latin and Central American countries (like Haiti). Symptoms begin with a sudden onset of painless watery diarrhea which can quickly become voluminous. Antibiotics regimen is also recommended in addition to adequate hydration. Health education and education in environmental control are critical for the prevention of cholera. Conclusions: Safe water supply and adequate sanitation and hygiene are the important routes for the control and prevention of cholera infection.