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Showing 2 results for Tavanaee Sani
Presenting features and outcome of rhino-orbital-cerebral mucormycosis in two referral center in Mashhad
Ashraf Tavanaee Sani , Abdol Majid Fata , Mahnaz Arian ,
Volume 72, Issue 1 (April 2014)
Abstract
Background: This study was done to determine presenting features and treatment out-come of Rhino-Orbital-Cerebral Mucormycosis (ROCM). Methods: This cross sectional study was conducted during 14 years (from 1998-2012) in two educational hospitals of Mashhad University of Medical Sciences in patients with rhino-orbital-cerebral mucormycosis. Clinical symptoms, predisposing factors, demografic parameter and treatment outcome were collected by SPSS and analyzed by cox regression model. Results: A total of 123 cases were (92 proven, 1 probable, 30 possible). From 92 cases of proven rhino-orbital-cerebral mucormycosis, 52% men and 48% women were rec-orded. The most risk factor were diabet 42.4% and immune deficiency 38%. From which 32 patients have hematologic malignancy (50% ALL, 37.5% AML, 6.3% aplas-tic anemia, 6.3% other). Mean time of admission in hospital were 30.1±29.3 days (1-230 days). The sign and symptoms were fever 41.3%, nasal ulceration or necrosis of palate 54.3%, orbital sign 59.7%, Headache 55.4%, central nervous system sign 28.2% and facial sign 53.2%. Median time between first symptoms and start of amphotricin B was 8.2±8.6 days. Treatment consist of both surgery and amphotricin B was done in 70.5% of patients. Mean number of surgery were 1.8±1.5. The mean time of mortality was 60.3±83 day. Thirty seven percent of patients survived with a 6 months follow up. Conclusion: Initial symptoms of sinus invasion by mucormycosis are indistinguishable from other more common causes of sinusitis. We must consider these diseases if there is nasal ulceration or necrosis of palate with fever and orbital sign. Diabet and immune deficiency are the most risk factor for rhino-orbito-cerebral mucormycosis. There is no relationship between age, predisposing factors and adverse effect of drugs with surviv-al. Progression to central nervous system in imaging pattern are related with hospital mortality. Treatment modality and number of surgery affect to mortality P= 0.001, P= 0.033. Survival was affected with the total dose of amphotericin B (P= 0.026).
Evaluation of clinical course and laboratory findings in HIV/HTLV-1 co-infection compare with HIV mono infection
Ashraf Tavanaee Sani , Lida Jarahi , Marzieh Saberi,
Volume 76, Issue 12 (March 2019)
Abstract
Background: In the last 10 years, co-infection of human immunodeficiency virus/human T-cell leukemia virus-1 (HIV/HTLV-1) has emerged as a worldwide health problem. These viruses has the same route to infect human but different effects on CD4 positive T-cells. There was controversial results about the influence of co-infection HIV/HTLV-1 pathogenesis. This study compared clinical course and laboratory findings in HIV/HTLV-1 co-infection with HIV mono infection.
Methods: This historical cohort study carried in Mashhad Consultation Center of Infective and Behavior Diseases, Mashhad, Iran, from April 2013 to march 2017. Persons who referred evaluated by the enzyme-linked immunosorbent assay (ELISA), then patients with positive ELISA test rechecked by ELISA and Western blot. Platelet count, WBC count, neutrophils count, positive CD4 T-cells, staging and disease severity evaluated at diagnosis, in starting and after of antiretroviral therapy in mono and co-infected patients. Demographic characteristics, including age, educational level, occupational state, marriage situation, past medical history and high-risk behaviors were extracted from the files.
Results: Of 64 patients enrolled in this study, 61 persons were male. Of 64 participants patients, 42 persons were infected with HIV (35 persons of them were positive for hepatitis C virus), other 22 positive HIV cases, were co infected by HTLV-1 too (18 persons were positive for hepatitis C virus (HCV). Co infected patients had more history of high-risk situations specially intravenous drug abuse. The most common opportunistic infections was cryptogenic tuberculosis (TB), candidiasis and military TB. Opportunistic infections and lab findings (except for CD4 positive T-cell) were the same in both group. Clinical severity and disease staging did not differ significantly between two groups. Death was more common in co-infected group.
Conclusion: Clinical course in human T-cell leukemia virus-1 (HTLV-1) co-infection has not obvious differences with previously HIV patients compare with only HIV infected patients. In co-infection with the onset of treatment the increase in the level of CD4 positive cells was higher than that HIV infection.

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