Background and Objective:
Primary immunodeficiency diseases (PIDs) are a group of
more than 350 disorders affecting distinct components of the innate and adaptive immune systems. In
this review, the classic and advanced stepwise approach towards the diagnosis of PIDs are simplified
and explained in detail.
Results:
Susceptibility to recurrent infections is the main hallmark of almost all PIDs. However, noninfectious
complications attributable to immune dysregulation presenting with lymphoproliferative
and/or autoimmune disorders are not uncommon. Moreover, PIDs could be associated with misleading
presentations including allergic manifestations, enteropathies, and malignancies.
Conclusion:
Timely diagnosis is the most essential element in improving outcome and reducing the
morbidity and mortality in PIDs. This wouldn’t be possible unless the physicians keep the diagnosis of
PID in mind and be sufficiently aware of the approach to these patients.
Background: The association between the use of antibiotics and bacterial resistance has obviously been established and it seems to be a significant problem for public health. It is clear that irrational use and high rates of antibiotic prescription are associated with increased bacterial resistance. As antibiotics are the class of drugs commonly prescribed in neonatal and Neonatal Intensive Care Unit (NICU) wards, neonates are at high risk of opportunistic or nosocomial infections due to prolonged hospitalization and immunosuppressed condition. Objectives: It is essential for antibiotic prescription patterns to be evaluated periodically for rational use. Therefore, the present study was carried out to identify the prescribing patterns of antibiotics in neonatal and NICU wards of 17 different Iranian hospitals. Methods: The study was done during 1 calendar week between January and February 2014. All in-patients admitted to the NICU and neonatal units of 17 Hospitals in 15 Iranian cities were included. Relevant data of all neonates receiving an antibiotic at 8 am on the day of the study was collected by trained members of the study team; age of the patients, type and number of administered antibiotics, route of administration, underlying disease, and indication for use were documented.
Background: Hydatid disease (HD) is still an important health hazard in the world. This disease is a parasitic infestation endemic in many sheep-and cattle-raising areas such as Iran. Objectives: This study aimed to review the clinical manifestations, laboratory aspects, imaging findings, and management of HD. Patients and Methods: Data were collected from the medical records of patients diagnosed with HD in eight referral hospitals in different provinces of Iran from 2001 to 2014. Results: Overall, 161 children at a mean age of 9.25 ± 3.37 years (age range = 1 -15 years old) hospitalized with a definite diagnosis of the hydatid cyst between 2001 and 2014 were studied. The male-to-female ratio was 1.6:1. The most commonly involved organ was the lung (67.1%), followed by the liver (44.1%) and a combined liver and lung involvement was found in 15.5% of the patients. The cysts were found more frequently in the right lobe of the liver and lung than in the left lobe. The most frequent complaints were fever (35.4%) and abdominal pain (31.7%), and the most frequent sign was an abdominal mass in the liver involvement and cough in the lung involvement. There was a high eosinophil count (> 500/micL) in 41% of our cases. A high erythrocyte sedimentation rate (> 30) or positive C-reactive protein (based on the qualitative method) was found in 18.6% of the patients and leukocytosis > 15000/micL in 29.2% of the children. Ultrasonography was the main imaging test, with an accuracy rate of 96%, and chest X-ray was helpful in 88.6% of the cases. Surgery was performed in 89% of the patients, and selective patients underwent percutaneous aspiration-injection-reaspiration drainage or medical treatment. Conclusions: The lung was the most commonly involved organ in the children recruited in the present study. Given the high probability of multiple organ involvement, we recommend that patients with HD be assessed via ultrasonography and chest X-ray. In endemic regions, unexplained eosinophilia should be considered as a parasitic disease like HD and its complications.
Background: It has been proposed that the migration of Toxocara canis larvae through the lungs is a contributing factor in the development of asthma and association of asthma and toxocariasis has been reported. The seroprevalence of toxocariasis varies widely among children living in different countries and even in different regions of a single country. Objectives: The aim of this study is to compare seroprevalence of anti-Toxocara antibodies in asthmatic and healthy children in Karaj, Iran. Methods: A serological study was conducted in children aged 1 to 15 years old for detection of antibodies to Toxocara canis in two groups (92 asthmatic children and 100 non-asthmatic children as control group), using commercial ELISA method for determination of IgG antibodies against Toxocara. Results: Only one patient (1.09%) had positive levels of anti-Toxocara antibodies in the case group, while no one had them in the control group. The results showed that there was no significant correlation between IgG antibodies against Toxocara canis and asthma. More than 90% of children in both case and control groups were residents of urban areas. Conclusions: We did not find any association between Toxocara infection and childhood asthma, suggesting that it may not be a common risk factor for childhood asthma in our urban area.
Introduction:
Parasitic myositis is caused by some parasites such as T. gondii and T. canis. So, the aim of the study was to evaluate the prevalence T. gondii and T. canis in patients with myositis and healthy individuals.
Methods:
A total of 108 samples were randomly selected as the control (54 healthy individuals) and test (54 myositis patients) groups. IgG and IgM antibodies against T. gondii and IgG antibodies against T. canis were measured by the ELISA. The detection of chronic and acute toxoplasmosis was performed by the ELISA IgG avidity. The presence of T. gondii in blood was evaluated by the nested-PCR.
Results:
Of 108, 33 (30.6%) cases were detected positive for IgG against T. gondii that 19 (35.2%) and 14 (25.9%) were observed in myositis patients and healthy individuals, respectively (P=0.296). Of 19 positive cases, 12 (63.2%) and 7 (36.8%) cases were detected as chronic and acute toxoplasmosis, respectively, while, all positive cases in the control group had chronic toxoplasmosis (P=0.013). One (1.9%) sample was detected positive for anti- Toxoplasma gondii IgM and two (3.7%) samples were found positive for IgG against T. canis by the ELISA that these positive cases were observed only in myositis patients (P=1.000 P=0.495, respectively). B1 T. gondii gene was amplified in 12 (63.2%) and 1 (7.1%) in myositis patients and healthy subjects (P=0.001).
Conclusions:
Our findings showed that there was a relatively high prevalence of acute toxoplasmosis in myositis patients in comparison with the control subjects in southwest of Iran.
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