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Background: Respiratory tract infections are one of the most important infections among military personals, worldwide. The present study aimed to survey the prevalence of bacterial and viral main etiological agents causing respiratory tract infections among the military personnel in Iran. A crosssectional study was performed from September 2020 to February 2021. Nasopharyngeal swabs were taken from patients, military personnel with respiratory tract infection symptoms. Detection of COVID-19 was performed with one step qRT-PCR method. TaqMan probe-based real-time PCR assay was used for the detection of in uenza A and B viruses. The prevalence of adenovirus and M. pneumoniae were determined using nested PCR. Moreover, B. pertussis and S. pyogenes were identi ed by conventional PCR assay. The detection of H. in uenzae was performed by multiplex PCR method.Results: Overall, 145 patients were included. Among viral pathogens, COVID-19, in uenza A virus, and adenovirus were identi ed in 85.5%, 4.1%, and 1.4% of patients, respectively. In uenza B virus was not detected among military personnel. The frequency of bacteria etiological agents was as follows: S. pyogenes (2%), M. pneumoniae (0.7%), H. in uenzae (0%), and B. pertussis (0%). Muscle aches (75.9%), headache (70.3%), lethargy (69%), cough (66.2%), stuffy nose (56.6%), fever (53.8%), and sore throat (53.1%) were amongst the most common clinical symptoms.Conclusions: Results showed that the military personals are the susceptible group to COVID-19 infection. Therefore, the accurate detection and implementation of control strategies such as vaccination are necessary.

As the novel Coronavirus pandemic continues to affect people worldwide, immune-mediated inflammatory syndromes have been reporting related to this virus. We presented a case of novel Coronavirus pneumonia, who developed a purpuric rash, abdominal pain, and hematuria, diagnosed with Henoch–Schoenlein purpura.

Background: Neutropenia is a common side effect of chemotherapy and one of the most common causes of severe infection and mortality in patients with hematological malignancies. Some studies showed that antimicrobial prophylaxis resulted in lower febrile neutropenia (FN) episodes and mortality rates. Objectives: We aimed to determine the efficacy of prophylaxis with ciprofloxacin in patients with hematological malignancies. Methods: In a randomized double-blinded clinical trial from 1 March to 1 September 2016, we assigned patients with chemotherapy-induced neutropenia into two groups. We used the random permuted blocks method for randomization. The first group received oral ciprofloxacin at a dose of 500 milligrams daily until the neutrophil count reached 1000 cells per microliter or fever occurrence, defined as the primary outcome. The second group received a placebo in the same shape and size. We compared FN episodes and the mortality rate in these two groups by SPSS-22 software, using chi-square, Fischer's exact tests, and student t-test at P-value < 0.05. Results: Seventy-three males (60.8%) and 47 females (39.2%) entered our study. The mean age of the patients was 47 ± 14.6 years. Acute leukemia was the most common underlying malignancy in 81 out of 120 subjects (67.5%). Fever (P = 0.005) was significantly lower in the ciprofloxacin group, but the mortality rate (P = 0.783) did not differ between the two groups. Conclusions: We found that the prophylaxis with ciprofloxacin decreased FN in our patients but did not influence the mortality rate. We believe that antimicrobial prophylaxis may be helpful in neutropenic patients, especially in decreasing FN and its related comorbidity.

BackgroundSevere acute respiratory syndrome (SARS) coronavirus-2 may infect red blood cells (RBCs) and impact oxygenation. We aimed to evaluate the efficacy of RBC exchange as an adjunctive treatment for hypoxemia and the survival rate of patients with severe coronavirus disease 2019 (COVID-19).MethodsIn a randomized clinical trial, we divided sixty patients with severe COVID-19 into two groups. The intervention group received the standard treatment of severe COVID-19 with RBC exchange three to four times in 2 days. The control group only received the standard treatment. Our primary outcomes were improving hypoxemia in 7 days, recovery or discharge, and death in 28 days. We conducted Chi-square test, independent samples t-test, and Fisher’s exact test to analyze the results. The ethical committee of Aja University of Medical Sciences approved the study (IR.AJAUMS.REC.1399.054), and the Iranian clinical trial registration organization registered it (IRCT20160316027081N2).ResultsTwenty-nine men and thirty-one women with a mean age of 67.5 years entered the study. The frequency of hypertension and diabetes mellitus was 86.7 and 68.3%, respectively. The most common symptoms of severe COVID-19 were dyspnea (91.6%), cough (75%), and fever (66.6%). Our results showed that hypoxemia improved in 21 of the 30 patients (70%) in the intervention group and 10 of the 30 patients (33.3%) in the control group (P &lt; 0.004). The recovery and discharge rates were 19 of 30 patients (63.3%) in the intervention group and 2 of 30 patients (6.7%) in the control group (P &lt; 0.001).ConclusionThe RBC exchange improved the oxygenation and survival rate in patients with severe COVID-19.

Background: Respiratory tract infections are one of the most important infections among military personals, worldwide. The present study aimed to survey the prevalence of bacterial and viral main etiological agents causing respiratory tract infections among the military personnel in Iran. A cross-sectional study was performed from September 2020 to February 2021. Nasopharyngeal swabs were taken from patients, military personnel with respiratory tract infection symptoms. Detection of COVID-19 was performed with one step qRT-PCR method. TaqMan probe-based real-time PCR assay was used for the detection of influenza A and B viruses. The prevalence of adenovirus and M. pneumoniae were determined using nested PCR. Moreover, B. pertussis and S. pyogenes were identified by conventional PCR assay. The detection of H. influenzae was performed by multiplex PCR method. Results: Overall, 145 patients were included. Among viral pathogens, COVID-19, influenza A virus, and adenovirus were identified in 85.5%, 4.1%, and 1.4% of patients, respectively. Influenza B virus was not detected among military personnel. The frequency of bacteria etiological agents was as follows: S. pyogenes (2%), M. pneumoniae (0.7%), H. influenzae (0%), and B. pertussis (0%). Muscle aches (75.9%), headache (70.3%), lethargy (69%), cough (66.2%), stuffy nose (56.6%), fever (53.8%), and sore throat (53.1%) were amongst the most common clinical symptoms. Conclusions: Results showed that the military personals are the susceptible group to COVID-19 infection. Therefore, the accurate detection and implementation of control strategies such as vaccination are necessary.

Introduction: Incidence of brucellosis was growing up in Iran during the past years. Kermanshah province-west of Iran is one of the endemic regions of the disease. The aim of this study was to evaluate the incidence and risk factors of brucellosis in Kermanshah province during a recent five-year period. Methods: This study was an observational cross-sectional study performed on registries of the patients with brucellosis at the center for the zoonotic disease of Kermanshah University of medical sciences during 2010-2014. The data was collected using a questionnaire containing demographic data and the risk factor of brucellosis. Collected data were analyzed by SPSS-22 software using descriptive statistic, Chi-square, and student t-test. Results: The five-years mean incidence of brucellosis in our study was 46.5 in one hundred thousand, and male to female ratio was 1.37/1. The most common risk factors of brucellosis in our patients were unpasteurized dairy products’ consumption (47%) and occupational contact with livestock (14.4%). 84% of the patients were rural. The most common diagnostic method was the standard agglutination test within 1/160 and 1/320 titers. Conclusion: Risk factors of brucellosis in our study were like other studies, but in more than onethird of the patients, no risk factor was identified. Lack of livestock vaccination history and incomplete registered data about other possible transmission routes of transmission were the limitations of the study.