Tarek Ameen is currently working as an Assistant Professor of Internal Medicine, Gastroenterology and Hepatology unit in Mansoura University. He also works as Consultant in Department of Gastroenterology and Hepatology in King Fahd Hospital.
Objectives: Th is work was done to investigate the predictors of mortality in non-survivors due to MERS-coronavirus infection. Methods: Th is study was conducted on 45 patients with coronavirus infection who were admitted in King Fahd hospital, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia during the period from October 2013 to June 2014. Th e studied patients were subjected to thorough medical history, clinical exam, complete laboratory investigations and nasal swabs and/or endotracheal secretion swabs for the intubated patients for detection of coronavirus by polymerase chain reaction (rRT-PCR). Treatment was carried out according to WHO guidelines and the outcomes were recorded by comparing the survivors with the non-survivors. Results: Th is study showed that most of the non-survivors were smokers, and presented with dyspnoea (88.9%), cough (83.3%), fever (94.4%) and bilateral radiological pulmonary infiltrates (83.3%). Twenty-seven patients (60%) out of the 45 studied patients, and 17 patients (94.5%) out of 18 non- survivors had at least one co-morbid condition. the duration of mechanical ventilation (MV), and the length of ICU and hospital stay were significantly prolonged in the non-survivors group compared to the survivors. Th ere was a statistically significant positive correlation between death and duration of illness before hospitalization, smoking severity, and presence of obesity, diabetes mellitus, end-stage renal diseases, and renal transplantations. Conclusions: Advanced age, smoking severity, bilateral radiological pulmonary infiltrates, and presence of associated comorbidities were risk predictors for mortality in hospitalized coronavirus-infected patients.
Sadaf Sabzevari is currently working as Assistant Professor at Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran. He has his expertise in vector borne diseases and interested in Pathobiology.
Cutaneous leishmaniasis (CL), caused by several Leishmania species, is a complex disease with a wide spectrum of clinical features. Th is neglected vector-borne disease, is a major public health problem worldwide and one of the most common endemic diseases in Iran. According to the World Health Organization (WHO) reports, about 900,000 to 1.3 million new cases of leishmaniasis are reported per year; of these, approximately 0.7–1.2 million are cutaneous leishmaniasis. It is estimated that 20,000 new cases are reported annually in Iran, nevertheless, due to under-reporting, the actual number is almost higher. North Khorasan province in North Eastern Iran is one of the important focus of CL, and this study was performed to determine the main parasites, reservoir hosts and vectors of the disease in this district. Leishmania positive isolates from human cases in North Khorasan province (North East of Iran) were genotyped using PCR-RFLP analysis. Wild mammals were caught from gerbil burrows and the genus and species of the rodents were determined by external morphological characteristics. Leishmania parasites were detected to assess the infection of reservoir hosts through microscopically methods, PCR-RFLP and phylogenetic analysis. Sand flies were collected by sticky papers and identified to species level using light microscope and keys. PCR of kDNA, ITS1-rDNA, followed by RFLP were used for identification of DNA of Leishmania parasites within infected sand flies. Th e results of this study indicated that the parasite causing cutaneous leishmaniasis in this province is L. major. The results also revealed that Rhombomys opimus is considered as the main reservoir host of CL. Microscopic investigation on blood smear of the animals for amastigote parasites and PCR-RFLP revealed the presence of L. major in rodents. Two species of Phlebotomus papatasi and Phlebotomus salehi were found to be naturally infected with L. major. Moreover, mixed infection of L. turanica and L. major was observed in one specimen of P. papatasi. Characteristics of the collected Leishmania isolates from North Khorasan revealed that L. major is a predominant parasite of cutaneous leishmaniasis. Our study revealed that R. opimusis the most important reservoir host for maintenance of the parasite source in the area. According to the results, two vectors of cutaneous leishmaniasis were found to be active in studied area. P. papatasi and P. salehi are, like in several places, the probable vectors of cutaneous leishmaniasis in this focus of cutaneous leishmaniasis. We also found that the disease is endemic in Northern Khorasan Province.