Amene S. Sarvestani; Gholamreza Pishdad; Shahram Bolandparvaz
Volume 2, Issue 1 , January 2014, , Pages 38-43
Abstract
Objectives: To determine the epidemiological aspect of mucormycosis, the nature of malignancies complicated by mucormycosis, the initial site of involvement and the subsequent outcome.Methods: This was a cross-sectional study which was performed by reviewing the medical records of 95 patients with leukemia ...
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Objectives: To determine the epidemiological aspect of mucormycosis, the nature of malignancies complicated by mucormycosis, the initial site of involvement and the subsequent outcome.Methods: This was a cross-sectional study which was performed by reviewing the medical records of 95 patients with leukemia complicated with biopsy-proven mucormycosis admitted to the educational hospitals affiliated with Shiraz University of Medical Sciences over a 21-year period. We recorded demographic information including age and sex and disease characteristics such as type of leukemia, site of involvement, paraclinical findings at the time of admission and the outcome of the patients. The incidence of mucormycosis in leukemia was determined by identifying the number of leukemia patients diagnosed within the last 17 years.Results: The male to female ratio was 2.39:1 in of 95 patients studied. The overall incidence rate of mucormycosis was 4.27 per 100 leukemic patients in last 17 years which showed a decreasing trend from 2001 to 2011. The most frequent type of leukemia was acute myelogenous leukemia (AML) which was found in 58 patients (61.5%). The most common site of initial tumor involvement was sinonasal (90.16%). The mortality rate was about 54%, compared to the mortality rate of about 43.24% in patients with best prognosis of AML.Conclusion: The incidence of mucormycosis in leukemia showed a decreasing trend in our country and its recent incidence is comparable to that of other regions. The best preventive method against this lethal infection is to modify and control the environment which reduces the risk of exposure to air-born fungal spores.
Mahnaz Yadollahi; Narges Shamseddini; Leila Shayan; Abbas Rezaianzadeh; Shahram Bolandparvaz
Volume 2, Issue 1 , January 2014, , Pages 44-51
Abstract
Objective: To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran.Methods: The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. ...
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Objective: To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran.Methods: The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. Each score is recorded in helical year which is defined from the 21th of March of every year until the 20th of March of the next. They are ranked and scored by knowledge production, capacity development, and research projects.Results: The total evaluation scores of the trauma research center of Iran's Universities of Medical Sciences have increased from establishment. The highest increase in assessment scores was related to Tehran Trauma Research Center. An upward trend was observed in the total indicators of knowledge production index of all the trauma research centers from 2001/2002 to 2011/2012. An ascending trend was showed in the published articles score of Shiraz and Kashan Trauma Research Centers through the recent years.Conclusion: The increasing trend in scores of trauma research centers in Iran indicated a significant role in the knowledge production but it is need to find barriers of research and doing interventional projects to promote trauma care and prevention.
Amene S. Sarvestani; Gholam Reza Pishdad; Shahram Bolandparvaz
Volume 1, Issue 4 , October 2013, , Pages 164-170
Abstract
Objectives: To determine the prevalence and predisposing factors of mucormycosis in patients with diabetes mellitus (DM) in a Shiraz referral centers.Methods: This retrospective case control study, reviewed the medical records of 162 patients with pathologically confirmed diagnosis of mucormycosis hospitalized ...
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Objectives: To determine the prevalence and predisposing factors of mucormycosis in patients with diabetes mellitus (DM) in a Shiraz referral centers.Methods: This retrospective case control study, reviewed the medical records of 162 patients with pathologically confirmed diagnosis of mucormycosis hospitalized in two major Shiraz University hospitals during the last 21 years. For each diabetic patient, two patients with diabetic ketoacidosis (DKA) matched for age, sex and the date of admission was selected as control group. Age, type of diabetes mellitus (DM) and duration of involvement as well as paraclinical findings were compared between cases and controls.Results: There were 162 patients with murormycosis of which 30 (18.5%) had DM as predisposing factor. Diabetes was the second common predisposing disease next to leukemia. There were 19 (63.3%) women and11 (36.7%) men among the patients. The overall mortality rate was 53.33% mortality rate. The mean age of the patients was 45.3 ± 17.6 years. The mean duration of diabetes in case and control groups were 5.75 ± 5.43 and 7.2 ± 7.85 years respectively, without any statistical significance between them (p=0.063). Blood sugar in patients was lower than control group (p=0.012). Serum bicarbonate level in case group was higher than in control group (p<0.001). Arterial pH in control group was more acidic than case group (p<0.001). Insulin dependent DM was significantly more prevalent in control group compared to case group (73.4% vs. 36.6%; p=0.002).Conclusion: Our study showed that the number of hospitalized patients with mucormycosis over the last 7 years has been decreased which is due to better control of infection in diabetics. In addition to hyperglycemia and acidosis, several other unknown factors like immune defects may predispose diabetics to this fungal infection.
Amene Sabzi Sarvestani; Mehdi Zamiri; Mehdi Sabouri
Volume 1, Issue 3 , July 2013, , Pages 116-122
Abstract
Objectives: To describe the characteristics and prognostic factors of 28 patients with Fournier’s Gangrene (FG) referred to our medical center at Southeastern Iran.Methods: This was a cross-sectional study including 28 cases of FG that were operated in Surgery department of Zahedan University of Medical ...
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Objectives: To describe the characteristics and prognostic factors of 28 patients with Fournier’s Gangrene (FG) referred to our medical center at Southeastern Iran.Methods: This was a cross-sectional study including 28 cases of FG that were operated in Surgery department of Zahedan University of Medical Sciences during a 10-year period from April 2002 to March 2012. The study analyzed 9 parameters including the body temperature, heart rate, respiratory rate, hematocrit, white blood count (WBC), and serum levels of sodium, potassium, creatininee (twice for 2 for acute renal failure), and bicarbonate for Fournier Gangrene Severity Index (FGSI) score. The aspects taken into account were age, gender, predisposing factors, duration of symptoms, hospitalization period, and number of debridements, disease outcome and the FGSI.Results: All patients were males, aged from 26 to 68 years, with mean age 44.6 ±8.49 years. Statistically significant differences in age (p<0.001), duration of symptoms (p=0.001), number of debridements (p=0.006), hospitalization duration (p<0.001) and FGSI (p<0.001) were found between surviving and dead patients. The mortality rate was 35.7%, and the most common presentation was perianal/scrotal pain (78.6%). Perianal and primary scrotal abscesses were most common causes of FG and were found in 57.14% and 21.42% of patients respectively. The most prevalent predisposing factor was diabetes mellitus in 12 (42.85%) patients. With respect to laboratory findings, statistically significant differences in WBC (p=0.002), creatinine (p<0.001), albumin (p<0.001), calcium (p<0.001) and serum sodium (p=0.035) were found between the surviving and dead patients.Conclusion: Serious outcome of FG was associated with old age, delayed diagnosis and treatment, inadequate surgical debridement, shorter hospitalization and higher FGSI scores. In addition higher WBC, higher creatininee and serum sodium and lower albumin and calcium levels implicated worse prognosis.
Shahram Paydar; Parisa Javidi Parsijani; Armin Akbarzadeh; Alireza Manafi; Fariborz Ghaffarpasand; Hamid Reza Abbasi; Shahram Bolandparvaz
Volume 1, Issue 3 , July 2013, , Pages 123-126
Abstract
Objectives: To evaluate the short-term outcome of open appendectomy, the rate of negative appendectomy as well as pathology reports after surgery in patients with suspected acute appendicitis.Methods: This was a retrospective cross-sectional study being performed in Nemazee hospital affiliated with Shiraz ...
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Objectives: To evaluate the short-term outcome of open appendectomy, the rate of negative appendectomy as well as pathology reports after surgery in patients with suspected acute appendicitis.Methods: This was a retrospective cross-sectional study being performed in Nemazee hospital affiliated with Shiraz University of Medical Science during a 2-year period between 2008 and 2010. The medical records of all consecutive patients who underwent open appendectomy in our center due to acute appendicitis were included in the study. The elective and laparoscopic appendectomies were excluded. The demographic information, clinical findings, laboratory investigations and the histopathological examination of the appendix were recorded and reported.Results: A total of 337 patient including 137 (36.4%) females, and 240 (63.6%) males with the mean age of 16.26 ± 9.81 (range 3 to 76) years were stduied. Anorexia (64.7%) and fever (20.7%) were more prevalent symptoms. The mean duration between pain initiation and operation ranged from 0 to 14 days with mean 1.88 ± 1.63 days. Right lower quadrant (RLQ), periumbilical, epigastria, left lower quadrant (LLQ), and Right upper quadrant (RUQ), pain were manifest in 78.8%, 41.6%, 12.2%, 3.2%, and 1.3% of patients, respectively. Pathological evaluation of the appendix showed appendicitis in 70.4% of patients.Conclusion: The higher rate of negative appendectomy accounts for wasteful tapping of medical resources and causing further complication in patients. Therefore it is essential to conduct more accurate studies to detect the root cause of the disease. This would help improve the management of appendicitis which is an emergency condition with high incidence.
