The epidemiological features and clinical manifestations of adult cases of brucellosis admitted to the Department of Infectious Diseases, Babol Medical University, Iran from 1997 to 2002 were investigated. Of 469 cases, 267 (56.9%) were males. The mean age of cases was 36.9 +/- 15 years. Most (60.8%) were from rural areas. Two thirds of cases (306, 66.3%) presented during spring or summer. Fresh cheese (22.4%), animal husbandry (11.3%), laboratory worker (8.1%) and veterinary profession (1.5%) were the main risk factors. Forty-five families (9.6%) had two cases. Sweating, fever, and arthralgia were the most frequent clinical symptoms. Complications were documented in 105 males (39.5%) and 41 females (20.3%, P=0.0001). Peripheral arthritis was seen in 24 (9%) males and 19 (9.4%) females, with knees and hips being the most common sites of infection. Sacroiliitis and spondylitis were seen in 28 (6%) and 32 (6.8%) cases respectively with spondylitis more common in males (P=0.023). Epididymo-orchitis was seen in 29 (10.9%) males. There were three cases each of endocarditis (0.6%) and neurological complications (0.6%). Most patients with brucellosis did not have any of the known risk factors for brucellosis. Thus consumption of unsafe dairy products could be the main route of infection. The disease manifested with a diversity of clinical manifestations and complications. Complications were more frequent in males than females.

This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.

Introduction: Duration of treatment for brucellar spondylitis in endemic regions is controversial. This study describes the outcome of treatment in 50 cases of brucellar spondylitis in Iran. Methodology: From April 2001 to September 2010, we treated 20, 13, 11 and 6 cases with doxycycline plus rifampin (DR), streptomycin plus doxycycline plus rifampin (SDR), cotrimoxazole plus doxycycline plus rifampin (CDR), and gentamicin plus doxycycline plus rifampin (GDR), respectively. Gentamicin and streptomycin were administered for 14 days and the other agents for 3 months. When complete clinical response was not achieved, therapy was continued. All patients were followed for one year. The Kaplan Meier method and the log rank test were used to compare the duration of therapy between SDR plus GDR patients with those treated with CDR or DR. Results: Eight (45%), 10 (76.9%), 7 (63.3%) and 6 (100%) cases treated for three months were cured with DR, SDR, CDR and GDR, respectively. Nine (45%), 4 (36.4%) and two (22.2%) were cured after four months with DR, CDR and SDR, respectively. Mean duration of therapy in the SDR plus GDR, CDR and DR was 3.26±0.17, 3.36±0.15 and 3.9±0.23 months, respectively (p=0.49 and p=0.015, respectively). Three cases with epidural or paravertebral abscesses recovered after six months. Relapse occurred in one (9.1%) and two (10%) cases treated with CDR and DR, respectively. Conclusions: Brucellar spondylitis could be treated using different combinations of antimicrobials especially with a regimen containing aminoglycoside for four months; patients with epidural or paravertebral abscesses require longer treatment times.

SAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.

This study indicates that BMD reduction in ICS user with asthma is dependent on age and appears that younger patients are at greater risk of BMD loss. These findings suggest preventive measures particularly in patients <50 years.

The results show that the efficacy of gentamicin for 5 days plus doxycycline for 8 weeks is not superior to that of streptomycin for 2 weeks plus doxycycline for 45 days.

In endemic regions of brucellosis, childhood brucellosis includes up to one-third of all cases of human brucellosis. The main source of infection in children is consumption of unpasteurized dairy products and traditional local foods containing dairy products. The older boys are more involved in animal care. Boys are more commonly infected than girls. Common symptoms and signs include fever, arthralgia, sweating, peripheral arthritis and splenomegaly. Peripheral arthritis especially monoarthritis is more common and the most commonly affected joints are hip and knee. All organs may involve during the course of the disease. Isolation of Brucella spp. from the blood, bone marrow or other tissue fluids is the hallmark of diagnosis. Serologic tests are the main tools of diagnosis of brucellosis in endemic regions. Standard agglutination test (SAT) with titers > 1:160 and the 2-mercaptoethanol (2ME) test ≥ 1:80 are suggestive of active infection. Children older than 8 years should be treated with doxycycline for 45 days or 8 weeks plus gentamicin for 7 or 5 days respectively or doxycycline for 45 days and streptomycin for 14 days. Also doxycycline plus rifampin or cotrimoxazole plus rifampin for 45 days may be alternative regimens. Cotrimoxazole plus rifampin for six weeks is the regimen of choice for the treatment of patients younger than 8 years old. Gentamicin for 5 days plus cotrimoxazole for six weeks may be a suitable alternative regimen. The article presented few of the patents associated with Brucellosis.

The tendency to use herbs to manage menopausal symptoms has increased in recent years. The purpose of this study was to evaluate the effect of Silybum marianum (L.) compared with placebo in women with hot flashes. Eighty women were randomly allocated into two equal groups (S. marianum extract [400 mg/d] or placebo capsules). Hot flashes frequency and severity were evaluated in 12 weeks with the Greene Climacteric Scale (GCS) and the Hot Flash Related Daily Interference Scale (HFRDIS). The data were analyzed in SPSS software using t‐test, Mann–Whitney, chi‐square test and repeated measure analysis. Hot flashes frequency and severity decreased from 4.32 ± 0.20/day to 1.31 ± 0.15/day and from 5.25 ± 0.22 to 1.62 ± 0.08, respectively, during the study in test group (p < .001) which were significantly better than effects of placebo in all steps of study (p < .001). Significant decreases in GCS and HFRDIS scores were also detected in S. marianum group compared with placebo after 4, 8 and 12 weeks (p < .001). The results showed that S. marianum can decrease frequency and severity of hot flashes significantly. Considering the safety and high consumption of this herbal medicine worldwide, its use in women with menopausal symptoms can be helpful.