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Background & aim: Pregnancy is every woman's stage of life. During this period, women experience physical, mental and social changes. It is very sensitive, challenging and therefore a critical period for every woman particularly in HIV-positive women. During pregnancy, an HIV-positive mother is facing a psychological crisis which includes fear of transmission to children, death, leaving children to the family or a guardian, adverse effects during pregnancy and the effects of pregnancy on their health. Therefore, HIV-positive pregnant women are vulnerable and require supportive interventions.  Care for pregnant women with HIV negative women are unique and different. However, no more information about experience of pregnancy in HIV positive women exists. Therfore, the aim of the present study was to explore the lived experience of pregnancy in HIV-positive women.

Methods: The present qualitative study with hermeneutic phenomenological approach included 12 HIV-infected pregnant women who referred to the counseling center for behavioral diseases at Imam Khomeini Hospital of Tehran University of Medical Sciences who were recruited through purposive sampling. Data were collected through semi-structured interviews. Data saturation was achieved after 16 interviews, each 40 to 90 min of duration with participants and then was analyzed by the method proposed by Diekelmann (1989).

Results: The participants in the present study were of 22- 39 years of age. After data analysis, the main themes and 3 sub-themes emerged. These themes included: “return to life” with the three sub-themes of experience of motherhood, stability and protection, and gratification.

Conclusion: The results revealed that although the experience of pregnancy in HIV-positive women was associated with a deep sense of fear of transmission of the disease and having children was viewed as a way of hope. Motherhood gave their lives meaning and provided for them to return to life. Understanding and awareness of all those are necessary for health care providers.The findings of this study emphasize on the need to design and implement comprehensive prevention strategies and interventions tailored to have a good feeling of pregnancy in these women.

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Abstract

Background and aim: Liver abscesses are the most common type of visceral abscess. The rare cases of liver abscess caused by F. hepatica infection has been reported. F. hepatica is Liver trematode common to humans and animals. F. hepatica have global emission and common in temperate, hot and humid zones especially in areas where livestock farming is common. The aim of this article is to report a case of liver abscess which was infected with F. hepatica.

Case Report: This Report is related to patient who initially diagnosed with liver abscess and taken medication for liver abscess, with no properly treated and refer by relapsing fever. After radiological studies and positive serology for F. hepatica the patient was undergo the treatment of fascioliasis and liver absecess. following the treatment the fever and liver lesion waer disappeared .  Reports of patients who initially diagnosed with liver abscess antibiotic treatment was that the abscess was not properly treated

Result: Given that, the new focus on F. hepatica infection which have been reported in southern Iran, in the all cases with fever and liver abscess in this geographic areas, F. hepatica considered in the differential diagnosis.

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Abstract
Background and aim: Blood culture is one of the methods of diagnosis of bacterial etiology of sepsis, but because of the low number of organisms in the blood or the use of antibiotics, separation of the organism causing sepsis is difficult in this way. This study was designed to determine the predictive factors for positive blood culture in sepsis patients.

Methods: The present historical cohort study was conducted on 320 patients with sepsis who were admitted to Shahid Beheshti Hospital in Kashan from October 2013 to October 2014. By examining patients' records, demographic, clinical and laboratory information including age, sex, hospitalization, temperature, pressure drop, tachycardia, tachypnea, serum CRP (CRP), white blood cell count (WBC), red blood cell sedimentation rate) ESR) and treatment outcomes. Data were analyzed using Chi-square, Mann-Whitney and t-test.
 
Results: The mean age of patients in the case group was 67.93 ± 12.12 years in the case group (case group) and 64.67 ± 13.87 in the negative control group (control group). Frequency of underlying disease, recent history of admission, hypotension and tachypnea in case group were more than control group. The results of logistic regression analysis indicated that serum reactive protein level, red blood cell dysplasia and white blood cell count are related to the outcome of blood culture in patients with sepsis.
 
Conclusion: Regarding the relationship between positive blood culture and inflammatory markers, in patients with sepsis, the increased inflammatory markers can be indicative of bacteremia and accelerate the onset of antibiotics and more precision in conducting blood cultures to discover the organism of sepsis.
 
 

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Background & aim: Bacterial meningitis is still recognized as one of the most dangerous infectious diseases that can lead to high mortality if not diagnosed and treated in a timely manner. The aim of this study was to determine the prevalence of bacterial agents causing meningitis and related factors in patients admitted to Imam Sajjad Hospital in Yasuj.
 
Methods:The present study was a cross-sectional descriptive-analytical study. The statistical population consisted of 106 patients one month to 14 years old referred to Imam Sajjad Hospital in 2018 who were analyzed for cerebrospinal fluid after clinical suspicion of meningitis. Spinal fluid sample of patients with white blood cell count greater than 5 was diagnosed as bacterial meningitis and one cc of it was stored at -20 ° C. Samples were analyzed for Meningococcus, Hemophilus influenza, Streptococcus pneumoniae and genotypes of this species using MULTIPLEX REAL TIME-PCR method by Tag Man method. Demographic, clinical and laboratory data were also collected and recorded. Data were analyzed using descriptive statistics and chi-square test.
 
Results: Of the total patients understudy, 33%(35) were female and 67%(71) were male. Most patients(50.9%) were between one month and one year of age. 34% (36 cases) of the specimens were confirmed as bacterial meningitis, 25 of which were pneumococcal and 11 of them were hemophilus influenzae type b. F19 genotype had the highest prevalence among pneumococcal genotypes. No positive results were found for meningococcus. Only one case of cerebrospinal fluid culture was positive, which was negative for coagulase staph. Also, only 8 cases(89.6%) had positive blood cultures. The most common clinical symptom was fever. There was a statistically significant difference between the negative PCR group and the positive PCR groups for vomiting (p=0.01), rash(p=0.03), Brodzinski(p=0.02) and underlying disease(p=0.002) and CSF(p=0/0009) existed.
 
Conclusion: According to the results obtained in this study, it can be concluded that pneumococcal and Haemophilus influenzae type b bacteria main cause of meningitis in children in the study, in addition to the cultivation of CSF and blood cultures correlate very poorly with results from PCR.
 
 

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Background & aim:  Acute respiratory disease caused by the new coronavirus (COVID-19), which was identified in December 2019, is rapidly progressing and spreading in the world and has been identified by the World Health Organization as a major global threat. Therefore, the aim of this study was to determine and investigate the relationship between underlying diseases and hospitalization in intensive care units in patients with Covid-19 in Yasuj.
 
Methods: Among the patients referred to the infectious department of Shahid Jalil Hospital in Yasuj, 48 real positive patients were selected based on clinical diagnostic tests (RT. PCR diagnostic test). Determination of underlying diseases was based on self-declaration during the questionnaire as well as patients' clinical history.
 
Results: Of the 48 patients admitted with COVID-19, 46% (23 patients) were reported to be patients with underlying disease, of which 20.83% were related to hypertension, 12.5% to diabetes, and 8.33% to ischemic heart disease (IDH), 4.34% had chronic obstructive pulmonary disease (COPD) and 2% had nominal disease. 20% of patients were admitted to the ICU. There was also a positive and significant relationship between hypertension, diabetes, myocardial ischemia and ICU admission.
 
Conclusion: Patients with any underlying disease had poorer clinical outcomes than those without the disease. More underlying diseases are also associated with poorer clinical outcomes and the need for hospitalization in the ICU.
 
 

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Background & aim: Hepatitis A is one of the most common viral infections in children that affects the liver and may be with or without symptoms. The disease is transmitted through oral-fecal excretion and its prevalence is clearly related to the level of health of the target community and is therefore one of the health problems of the world and developing countries. Hepatitis A is present in all parts of the world, but its prevalence varies in different parts of the world. Therefore, the aim of the present study was to determine and evaluate the prevalence of hepatitis A in children in Yasuj.
 
Materials: The present descriptive cross-sectional study was conducted in 2015. Three hundred and seventy nine children aged one month to 15 years entered the study and were selected by quota sampling method. The blood serum sample of the sample group in the laboratory was examined by ELISA for hepatitis A antibody. To assess the relationship between age, parental education, income level, area of residence, gender and use of kindergarten with hepatitis were examined. Data were analyzed using chi-square test and gamma tracking.
 
Results: The results indicated that in this study, the prevalence of hepatitis A in Yasuj city was 11.6% (44 people). The two analyzes revealed a significant association between the prevalence of hepatitis A with age (x²=78/38) at the level (p=0.01), and children under one year of age had the highest incidence and children aged one to 5 years had the lowest incidence (relative to group population). There was no significant relationship between the prevalence of hepatitis and gender, the level of education of parents and family income.
 
Conclusion: According to the results of the prevalence of hepatitis A, it is necessary to pay more attention and training to older groups at higher risk in order to prevent and reduce the damage.
 
 

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Background & aim: Opportunistic fungal infections following COVID-19 is problematic. Antifungal medications are as well used to treat people who have fungal infections. The aim of the present study was to evaluate the prevalence of fungal infections and the usage of antifungal medications before and after the COVID-19 pandemic.

Methods: The present descriptive, analytical, and retrospective study was conducted in 2021.The records of patients who were hospitalized in Abadan hospitals in the year before or the first two years of the COVID-19 pandemic and received at least one of the antifungal medication’s fluconazole, caspofungin, or amphotericin B were extracted and assessed for the present study. Demographic information of patients, type of ward, and type of fungal infection, history of previous infection with covid-19 and severity of disease were extracted from patient files. Descriptive analysis, chi-square, and ANOVA statistics were used to analysis the data.

Results: The results indicated that the mucormycosis and aspergillus fungal infections had dramatically increased in the two years since the COVID-19 pandemic initiated. Although it was not statistically significant, the usage of antifungal medications rose in the two years following the beginning of COVID-19 compared to the prior two years. The mucormycosis fungus was the most prevalent fungal infection. The lung was the most commonly infected organ. All patients with fungal infection had a history of severe COVID-19 following the COVID-19 pandemic. The most often used medication was amphotericin B. This difference was substantial (P< 0.001) when aspergillosis patients received capsofungin, mucormycosis patients received amphotericin B, and candida patients received fluconazole.

Conclusion: The present indicated that aspergillosis and mucormycosis fungal infections were more common during the COVID-19 pandemic, and as a result, antifungal medication use has increased as well. Additionally, all three medications (fluconazole, caspofungin, and amphotericin B) were administrated according guidelines.

 

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Background & aim: The use of antibiotic prophylaxis in the treatment of burns is a controversial issue. Many specialists start antibiotic treatment after the patient is admitted to prevent infection, while in most cases, antibiotic use is not necessary. The aim of the present study was to determine the relationship between the use of antibiotic prophylaxis on mortality, infection and drug resistance in burn patients without sepsis symptoms admitted to Amir al-Momenin Burn Injury Hospital.

Methods: The present analytical-cross-sectional study was conducted in 2020-2021 at Amir al-Momenin Burn Injury Hospital, Shiraz, Iran. 2982 patients were included in the study. Patients' information, results of bacterial culture and antibiotic resistance of isolated isolates were extracted from burn patients' registry system and health information system. Descriptive statistics and the collected data were presented in tabular form. Quantitative data were summarized as mean and standard deviation and qualitative data as frequency and percentage graphs. Statistical analysis was analyzed for the association of results using paired t-test and chi-square. The level of statistical significance in all tests was considered P≤0.05.

Results: Antibiotic resistance in hospitalized patients with prophylaxis treatment was 54.30%. The rate of mortality and re-hospitalization of patients in patients with no antibiotic prophylaxis was zero; In addition, the blood, liver and kidney factors of the patients were within the normal range. There was no significant difference between platelet levels, alkaline phosphatase serum level, alanine aminotransferase, blood urea nitrogen level and its ratio to creatinine (P≥0.05) on the first day of hospitalization and at the time of discharge. On the other hand, there was a significant difference between the levels of white blood cells, neutrophils and albumin (P<0.001) in the first three days of hospitalization and the time of discharge.

Conclusion: The use of prophylactic antibiotics had no effect in the treatment of burn diseases without infection, and in order to reduce microbial resistance, it is better to avoid unnecessary use of antibiotics in burn areas.