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Article ; Online: A Potential Role of Cytomegalovirus Reactivation in the Severity of COVID-19 in the Elderly

Shabnam Tehrani / Amirreza Keyvanfar

Novelty in Biomedicine, Vol 10, Iss 2, Pp 142-

2022 Volume 143

Abstract: In late 2019, severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China. This virus spread quickly worldwide, with millions of victims until now. The clinical manifestations of the novel coronavirus disease (COVID-19) are ...

Abstract	In late 2019, severe acute respiratory syndrome- coronavirus-2 (SARS-CoV-2) was reported in Wuhan, China. This virus spread quickly worldwide, with millions of victims until now. The clinical manifestations of the novel coronavirus disease (COVID-19) are a broad spectrum, from asymptomatic and mild cases with a flu-like syndrome to severe cases requiring intensive care1. The severity of diseases and risk of mortality is higher in the elderly, which most authorities attribute to underlying conditions, including diabetes, hypertension, cardiovascular diseases, and respiratory diseases. However, some neglected factors, such as cytomegalovirus (CMV) reactivation, can affect patient outcomes2.
Keywords	covid-19 ; cytomegalovirus ; opportunistic infections ; prognosis ; sars-cov-2 ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Detection of Carbapenems and Colistin Resistance Genes in Pseudomonas aeruginosa and Acinetobacter baumannii

Shabnam Tehrani / Hamed Samami / Amirreza Keyvanfar / Ali Hashemi

Novelty in Biomedicine, Vol 10, Iss 3, Pp 178-

A Single-center Study in Iran

2022 Volume 183

Abstract: Background: This study aimed to determine carbapenems, colistin resistance genes, and antimicrobial susceptibility profiles of Pseudomonas aeruginosa and Acinetobacter baumannii isolates. Materials and Methods: In this cross-sectional study, specimens of ...

Abstract	Background: This study aimed to determine carbapenems, colistin resistance genes, and antimicrobial susceptibility profiles of Pseudomonas aeruginosa and Acinetobacter baumannii isolates. Materials and Methods: In this cross-sectional study, specimens of patients with bloodstream, urinary tract, and surgical site nosocomial infections were enrolled. P. aeruginosa and A. baumannii isolates were identified using conventional methods. Antimicrobial susceptibility testing (AST) on isolates was performed using the disk diffusion method and minimum inhibitory concentration (MIC) for colistin as recommended by the Clinical and Laboratory Standards Institute (CLSI). The combination meropenem disk method was used to detect metallo-β-lactamases (MBLs). The blaNDM, blaVIM, blaIMP, and mcr-1 genes were identified using the polymerase chain reaction (PCR) method and Sequencing. Results: Forty strains of P. aeruginosa and forty strains of A. baumannii were isolated from hospitalized patients. The overall prevalence of multidrug-resistance (MDR) was 50% and 95% in P. aeruginosa and A. baumannii isolates, respectively. Almost all the MDR isolates were resistant to cefepime and piperacillin. Colistin had significant inhibitory activity against the isolates. MBL was detected in 25.0% and 15.0% of clinical isolates of P. aeruginosa and A. baumannii, respectively. We detected no blaNDM, blaVIM, blaIMP, and mcr-1 genes in our A. baumannii isolates. Moreover, only three P. aeruginosa isolates were positive for blaIMP gene. Conclusion: The alarming proportion of MDR P. aeruginosa and A. baumannii isolates was reported in the current study. Effective infection prevention practices are required and AST should guide patients' treatment.
Keywords	acinetobacter baumannii ; pseudomonas aeruginosa ; multidrug-resistance ; metallo-β-lactamase ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of the Efficacy of Cefazolin with and without Naproxen in Patients with Cellulitis Admitted to a Tertiary Hospital

Shabnam TEHRANI / Behnood HATAMI / Sadaf SAKET / Amirreza KEYVANFAR

Mediterranean Journal of Infection, Microbes and Antimicrobials, Vol 11, Iss

2019-2020

2022 Volume 1

Abstract: Introduction: It is pertinent to carefully monitor the clinical course of patients with cellulitis. If not treated properly, there is a possibility of its extension to other skin surfaces, recurrent infection, risk of systemic spreading, and incidence of ...

Abstract	Introduction: It is pertinent to carefully monitor the clinical course of patients with cellulitis. If not treated properly, there is a possibility of its extension to other skin surfaces, recurrent infection, risk of systemic spreading, and incidence of worse complications, such as sepsis and severe abscesses. Various antibiotic regimens with or without anti-inflammatory drugs have been administered as a treatment against cellulitis. However, there is no proposed standard and selective line of treatment against cellulitis. This study aimed to compare the efficacy and outcome of two medications, cefazolin alone and cefazolin combined with naproxen as a non-steroidal anti-inflammatory drug. Materials and Methods: This open-label randomized clinical trial was conducted on patients with cellulitis who were admitted to Labbafinejad Hospital (Tehran, Iran) from May 2019 to March 2020. The patients were randomly divided into group A (treated with 1-1.5 g of cefazolin alone intravenously every eight hours) and group B (treated with 1-1.5 g of cefazolin intravenously every eight hours combined with 500 mg of naproxen orally every 12 hours). The responses to these medications and the side effects were evaluated during hospitalizations. Results: The mean age of the 64 patients included in the study was 50.52±2.10 years and 51.56% of the patients were male. There were no significant differences between the control (n=33) and intervention (n=31) groups in terms of history of diabetes mellitus (p=0.666), antibiotic use (p=0.594), trauma (p=0.722), cellulitis (p=0.529), and smoking (p=0.705). The mean body temperatures of the two groups were not different in any of the first (p=0.762), third (p=0.789), and fifth (p=0.893) days. The improvement of clinical symptoms on the third day was significantly (p=0.045) more in group B (90.3%) than in group A (51.5%). Also, the clinical improvement on the fifth day was significantly (p=0.036) higher in group B (100%) than in group A (69.7%). In addition, the mean hospitalization periods ...
Keywords	cellulitis ; treatment outcome ; cefazolin ; naproxen ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
Subject code	616
Language	Turkish
Publishing date	2022-04-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Echocardiographic Findings of ICU-Admitted COVID-19 Patients

Hossein Hatami / Mohammad Ali Akbarzadeh / Latif Gachkar / Amirreza Keyvanfar

Novelty in Biomedicine, Vol 10, Iss 2, Pp 107-

a Multicenter Retrospective Study

2022 Volume 114

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has left many victims and caused many problems for the healthcare systems of different countries. Many COVID-19 patients have cardiovascular complications, which are detectable using ... ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic has left many victims and caused many problems for the healthcare systems of different countries. Many COVID-19 patients have cardiovascular complications, which are detectable using echocardiography. This study aimed to determine the echocardiographic findings and their association with mortality in an intensive care unit (ICU)-admitted COVID-19 patients. Materials and Methods: In this retrospective study, COVID-19 patients admitted to the ICU of four hospitals in Tehran, Iran, from April 2020 to March 2021 were recruited. Data were collected by the census method. We reviewed the medical records regarding demographic features, clinical history, laboratory results, and echocardiographic findings. Finally, variables were compared regarding disease outcomes at the end of hospitalization. We used the Chi-square test, Fisher’s exact test, independent-samples t-test, and logistic regression model to analyze the data. Results: This study showed that the mean age of 629 COVID-19 patients was 66.42±14.53 years. Overall, 56.8% of the patients were male. Multivariate regression analysis showed that age (OR=1.03; 95% CI: 1.01-1.05), left ventricular ejection fraction (OR=0.95; 95% CI: 0.92-0.98), and systolic pulmonary arterial pressure (OR=1.12; 95% CI: 1.06-1.18) were predictors of mortality. Conclusion: Cardiovascular involvement is prevalent among critically ill COVID-19 patients. Among echocardiographic findings, EF and s-PAP were significantly associated with the disease outcomes.
Keywords	covid-19 ; cardiovascular disease ; echocardiography ; mortality ; sars-cov-2 ; Medicine (General) ; R5-920
Subject code	310 ; 610
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Randomized Controlled Trial

Davood Yadegarynia / Shabnam Tehrani / Amirreza Keyvanfar / Latif Gachkar / Behnaz Najafi

Novelty in Biomedicine, Vol 10, Iss 4, Pp 213-

Colistin Alone or Colistin and Meropenem: Which Is More Effective for the Management of Urinary Tract Infections?

2022 Volume 218

Abstract: Background: Colistin is a common antibiotic used to treat urinary tract infections (UTIs) caused by gramnegative bacteria. In recent years, due to the increasing resistance, consumption of colistin alone could lead to treatment failures. This study aimed ...

Abstract	Background: Colistin is a common antibiotic used to treat urinary tract infections (UTIs) caused by gramnegative bacteria. In recent years, due to the increasing resistance, consumption of colistin alone could lead to treatment failures. This study aimed to compare the effectiveness of colistin alone with colistin and meropenem to treat patients with urinary tract infections. Materials and Methods: In this randomized, open-label, parallel groups controlled trial, hospitalized patients with urinary tract infections were included. Patients were randomly allocated to the control group (n=35) that received colistin (1 mIU every 12 hours) and the intervention group (n=35) that received colistin (1 mIU every 12 hours) with meropenem (1gr every 8 hours). An infectious disease specialist evaluated the therapeutic responses 48-72 hours after admission. Cessation of fever, improvement of symptoms and signs, and negative urine culture within 48 hours were considered successful therapeutic responses. Results: The mean length of hospitalization was longer in the control group (4.74±0.78 days) compared with the intervention group (4.26±0.56 days) (P=0.004). The prevalence of fever cessation had no significant difference between the two groups at any time (P>0.05). Also, there was no significant difference between the two groups at any time, considering vital signs, irritative urinary symptoms, nausea and vomiting, and flank pain (P>0.05). Conclusion: The administration of colistin and meropenem to treat UTIs was associated with a shorter length of hospital stay. However, regarding response to treatment, it did not matter if they were treated with colistin alone or with combination therapy (colistin and meropenem)
Keywords	colistin ; drug resistance ; gram-negative bacteria ; meropenem ; urinary tract infections ; Medicine (General) ; R5-920
Subject code	610 ; 630
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy of Favipiravir in the Treatment of Moderate COVID-19 Patients

Shabnam TEHRANI / Davood YADEGARYNIA / Afshin BAGHERZADE / Latif GACHKAR / Amirreza KEYVANFAR

Mediterranean Journal of Infection, Microbes and Antimicrobials, Vol 11, Iss

A Randomized, Open-label, Controlled Clinical Trial

2022 Volume 1

Abstract: Introduction: Since the beginning of the Coronavirus disease-2019 (COVID-19) pandemic, scientists have studied many drugs to treat it, but none of them have been approved as a complete cure. Favipiravir is one of those drugs that effectively clears the ... ...

Abstract	Introduction: Since the beginning of the Coronavirus disease-2019 (COVID-19) pandemic, scientists have studied many drugs to treat it, but none of them have been approved as a complete cure. Favipiravir is one of those drugs that effectively clears the body from the virus by interfering with the process of replication. This study aimed to determine the efficacy of favipiravir compared with supportive medication to treat moderate COVID-19 patients. Materials and Methods: In this randomized, open-label, controlled clinical trial, we examined the efficacy of favipiravir to treat moderate COVID-19 patients. The study was conducted in Labbafinejad Hospital (Tehran, Iran) from April to September 2021. A 1:1 ratio of eligible patients were assigned to the intervention and control groups. The control group received supportive medication. In addition to supportive medication, the intervention group received favipiravir. The primary endpoint was the hospitalization rate during the seven-day follow-up. And the secondary endpoints were symptoms, signs, and laboratory tests of the patients. Results: Out of 78 patients who were included in the study, 40 patients were assigned to the control group and 38 patients were assigned to the intervention group. At the beginning of treatment, the respiratory rate was higher in the intervention group (p=0.001), however, on the fifth (p=0.001) and seventh (p<0.001) days, it was significantly lower in the intervention group. In addition, oxygen saturation at the beginning of treatment was lower in the intervention group (p<0.001); however, on the fifth (p=0.016) and seventh (p<0.001) days, it was significantly higher in the intervention group. Furthermore, the consumption of favipiravir was not associated with the hospitalization rate (p=0.200). Conclusion: Favipiravir enhances respiratory manifestations in patients with moderate COVID-19 when compared to supportive medication alone.
Keywords	antiviral agents ; covid-19 ; favipiravir ; sars-cov-2 ; Medicine ; R ; Infectious and parasitic diseases ; RC109-216
Subject code	610
Language	Turkish
Publishing date	2022-08-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Side Effects of COVID-19 Vaccination Among Healthcare Workers in Tehran, Iran

Davood Yadegarynia / Shabnam Tehrani / Fahimeh Hadavand / Shahnam Arshi / Zahra Abtahian / Amirreza Keyvanfar / Azar Darvishi / Afshin Zarghi

International Journal of Medical Toxicology and Forensic Medicine, Vol 13, Iss

2023 Volume 3

Abstract: Background: Since the emergence of coronavirus disease 2019 (COVID-19), many people have been vaccinated worldwide. Despite the preventive role of vaccines, their side effects face disease management with challenges. This study aims to investigate the ... ...

Abstract	Background: Since the emergence of coronavirus disease 2019 (COVID-19), many people have been vaccinated worldwide. Despite the preventive role of vaccines, their side effects face disease management with challenges. This study aims to investigate the side effects of COVID-19 vaccination among healthcare workers in Tehran, Iran. Methods: This cross-sectional study was conducted from April to October 2022 on 377 healthcare workers in Tehran, Iran. Data collection was carried out through an interview by a researcher using a checklist assessing systemic and local side effects of COVID-19 vaccines. Results: The mean age of participants was 36.03±10.24 years, and 68.2% were female. Participants experienced significantly more local (26.5% vs. 14.3%, P<0.001) and systemic (52.0% vs. 31.8%, P<0.001) side effects after the first dose than after the second dose. After the first dose, AstraZeneca (45.9%) caused significantly more local reactions than Sputnik V (21.7%) and Sinopharm (14.5%). AstraZeneca (83.7%) caused significantly more systemic side effects than Sputnik V (50.7%) and Sinopharm (14.5%). The prevalence of local and systemic side effects after the first dose was significantly different in terms of vaccine types (P<0.001). After the second dose, AstraZeneca (20.4%) caused significantly more local reactions than Sputnik V (12.8%) and Sinopharm (10.5%) (P<0.001). Additionally, AstraZeneca (38.8%) and Sputnik V (37.4%) caused significantly more systemic side effects than Sinopharm (7.9%) (P<0.001). Conclusion: Most healthcare workers in Tehran experienced flu-like symptoms and local reactions at the injection site after vaccination against COVID-19, mainly after the first dose. They had more side effects after vaccination with AstraZeneca and Sputnik V, compared to Sinopharm.
Keywords	adverse effects ; covid-19 vaccines ; iran ; safety ; sars-cov-2 ; Medicine (General) ; R5-920 ; Toxicology. Poisons ; RA1190-1270
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Shaheed Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Assessing Attitudes of Medical Students towards First Contact with Patient in Tehran (2016-17)

Eznollah Azargashb / Mohamad Ali Heidarnia / Mohamad Mehdi Derisi / Amir Zamani / Amirreza Keyvanfar / Mohammad Mohammadi / Nima Sadeghzadeh / Mirsaid Mousavifar

Novelty in Biomedicine, Vol 6, Iss 1, Pp 15-

2018 Volume 20

Abstract: Background: Early experience of clinical arena as first situations can be effective in selection or refusing medicine as profession is so important that programmers and administrators should consider these settings as one of the most elements in ... ...

Abstract	Background: Early experience of clinical arena as first situations can be effective in selection or refusing medicine as profession is so important that programmers and administrators should consider these settings as one of the most elements in educational programs. M aterials and Methods: This study was a cross-sectional study and including presently studying students in medicine field of medical sciences universities. Sample size was estimated for 275 students. Participants were selected from schools of medicine: Iran University (IUMS), Shahid Beheshti University, and Islamic Azad University using stratified random sampling method. Data was collected in March of 2016 by a researcher made questionnaire determined its validity and reliability. Data was analyzed using chi-squared test, t-test, Mann-Whitney and Kruskal-Wallis test. R es ults: Mean score of medical students’ attitude from 15 five-degree scale questions was 51.22 ± 6.32. The mean scores of attitude in men and women were 51.37±6.16 and 51.06±6.53, respectively (p=0.687). Overall, 13.8 % of students had positive attitude towards first contact with patient, 10.5 % of students had negative attitude and 75.6 % had no opinion. The mean scores of attitude towards first contact with patient in Iran university, Shahid Beheshti university and Islamic Azad university were 50.40±5.00, 52.71±5.91 and 46.12±5.97, respectively (p<0.001) . The mean scores of attitude towards first contact with patient in reformed educational system and old educational system were 52.35±5.83 and 46.12±5.97 respectively, with a significant difference between two types of educational system (p<0.001). C onclusion: As respects more positive attitude of students in reformed educational system in comparison with old educational system, special attention to courses of early contact with patient may contribute to decreasing educational insufficiency and distance between theory and practice and lead to the satisfaction all of beneficiaries.
Keywords	first clinical experience ; medical students ; attitude ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Shahid Beheshti University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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