This study aims to investigate the clinical and demographic features of underlying medical conditions and the potential relationship between underlying diseases and the increased rate of morbidity and mortality due to COVID-19.
Serological assays for diagnosis of tuberculosis (TB) are very attractive because they are inexpensive, non invasive and simple. Present study was conducted to evaluate the tuberculosis rapid test device in Iran.The tuberculosis rapid test device based on detection of IgM, IgA and IgG antibodies against 6, 16 and 38-kDa antigens of Mycobacterium tuberculosis via chromatography was used in 96 cases of pulmonary and extra pulmonary TB. Fifty four patients with conditions other than TB were selected as the control group. Tuberculin skin test (TST) was performed in two groups. None of the patients were immunodeficient. All of them were evaluated in terms of presence of BCG scar.Tuberculosis rapid test was positive in 75 cases (78.1%) and 15 controls (27.8%). This difference was statistically significant (P-value < 0.001). TST was positive in 66 patients (68.8%) with tuberculosis and 10 (18.5%) controls with no statistically significant difference (P-value = 0.065). Sensitivity, specificity, positive and negative predictive values of the tuberculosis rapid test for diagnosis of tuberculosis were 78.1%, 72.2%, 83.3% and 65%, respectively. These parameters for TST were 31.3%, 81.5%, 75%, and 40%, respectively.Tuberculosis rapid test has better sensitivity than TST and may be helpful in diagnosis of tuberculosis as a complementary test or in epidemiological investigations.
The study aimed to assess possible spirulina effects on lipid profile, glucose, and malondialdehyde levels in new cases of type 2 diabetes. The subjects consisted of 30 new cases of types 2 diabetes that divided into two groups; each consisted of 15 diabetic patients. Group I did not take any functional food or supplement and received no spirulina supplementation. Group II or experimental group also did not take any functional food or supplement but received spirulina supplementation. Analysis of data was done using SPSS 16.0. The Kolmogorov-Smirnov test, paired t-test, Wilcoxon test, and Spearman correlation analysis were used to analyze the data. After eight weeks of spirulina supplementation, significant differences were shown in the serum levels of total cholesterol, low-density lipoprotein (LDL)-cholesterol, triglyceride, and malondialdehyde. The serum fasting blood glucose, lipid profiles, and malondialdehyde levels at baseline were negatively and positively correlated with changes in these parameters. Spirulina supplementation may have a beneficial effect on lipid profile and malondialdehyde (MDA) levels through an interventional 8 weeks. This effect may protect subjects against free radicals and the development of some diseases such as atherosclerosis. The spirulina supplementation also showed a potential lipid-lowering effect on new case type 2 diabetic patients which may help the diabetics to have control on lipid levels. In addition, spirulina may be used as a functional food for the management of lipid profiles and MDA levels.
Pulmonary actinomycosis is a rare bacterial lung infection which is caused mainly by Actinomyces israelii. This non contagious infection can destroy parts of the lungs. There are variable presentations of pulmonary actinomycosis with similarity in manifestations to other infectious diseases of the lungs. Pulmonary actinomycosis is diagnosed by fine needle aspiration, bronchoscopy and finding of typical sulfur granules. We present a case of pulmonary actinomycosis in a middle aged (AIDS/HCV) man with massive hemoptysis and progressive dyspnoea. The bronchoscopy findings showed endobronchial mass with luminal occlusion in right upper lobe. Because of massive hemoptysis and poor response to conservative treatment and penicillin therapy, right upper lobectomy was needed to stop the bleeding. Histopathologic examination revealed the aggregations of filamentous Gram-positive organisms with characteristic pattern "sulfur granules", indicating actinomycosis. The patient was followed by six months of oral amoxicillin and has no recurrent hemoptysis.
Objectives The risk relationship between diabetes and tuberculosis is largely suggested by epidemiological evidences but the preferred method for screening of DM among TB cases has not been determined. This study performed to compare efficacy of fasting blood sugar (FBS) and glycosylated hemoglobin (Hb A1c) for screening of DM among TB cases. Methods In a prospective study, 221 new cases of tuberculosis were recruited in National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran. On the first day of TB diagnosis and before initiation of anti tuberculosis drugs, fasting blood sugar and glycosylated hemoglobin were measured. DM was defined as FBS more than 126 mg/dl or Hb A1c more than 6.5%. After exclusion of known cases, rate of new cases of DM diagnosed by every test was measured. Results Among 221 new cases of tuberculosis, Sixty seven patients had FBS>126 mg/dl and Hb A1c was more than 6.5% in 134 persons. History of DM was positive for 31and 112 cases were found after TB diagnosis. Hb A1c was more sensitive than FBS for diagnosis of DM (92% in comparison to 32%). Nine cases of recently diagnosed DM had normal level of HbA1c but FBS>126 mg/dl. Conclusion DM was very common among new cases of tuberculosis in our setting. Majority of DM cases were unaware of their disease. Measurement of Hb A1c is more effective than FBS for screening of DM among tuberculosis patients.
Background: We intend to assess the frequency of adverse effects of tuberculosis treatment in HIV patients. Methods: The study was conducted at National Tuberculosis referral center in Iran, 2005-2010 including all documented TB patients with HIV co-infected. All patients received anti-TB treatment based on National TB Program. All adverse effects (AE) observed in patients were recorded in our registry. Results: Of the total 151 TB/HIV patients, 81 (53.6%) developed adverse effects (AE) whether major or minor. Major AE (65) included hepatitis (46), convulsion (4), thrombocytopenia (17), rash (5) that 86.2% of them had CD4 Conclusion: This study showed that major adverse effects do not affect to outcome of TB treatment.
Abstract Background We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7 , with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10 −4 ) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10 −4 ). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10 −3 ), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10 −8 ). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10 −5 ). Conclusions Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old.
Background: A significant link between diabetes mellitus (DM) and tuberculosis (TB) has been widely demonstrated. DM increases the risk of TB in all aspects. The aims of this study were to assess the prevalence of DM among newly diagnosed TB patients, to screen these patients for DM, and to determine the number needed to screen (NNS) to diagnose new cases of DM. Methods: A prospective cohort descriptive study was carried out in Iranian adults admitted to the National Research Institute of Tuberculosis and Lung Disease from 2012 to 2013 with a new diagnosis of TB. Glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) were measured for all patients. Results: Of the 293 patients included, 101 (34.5%) had DM. DM was newly diagnosed in 45 (19%) patients. The number needed to screen was 5 to identify one new DM case. Age ≥ 40 years was associated with DM in this population (odds ratio (OR) = 3.91, 95% confidence interval (CI) = 1.47–10.38). Conclusion: Screening for DM should be performed routinely in patients with TB and may improve treatment outcomes.
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