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Background and purpose: Influenza is a seasonal respiratory illness that affects all age groups and causes excess mortality. Identifying the clinical manifestations and complications could be of great value in preventing the flue pandemic. Recent H1N1 pandemic is associated with some unusual findings such as thrombocytopenia, leukopenia, and lymphopenia which are not reported in other types of Influenza. Herein we investigate the hematological manifestations of influenza patients. Materials and methods: This study included all patients with flu symptoms attending Sari Imam Khomeyni Hospital and Qaemshahr Razi Hospital, winter 2015. H1N1 influenza infection was confirmed by polymerase chain reaction from nasopharyngeal specimen received through nasopharyngeal swabs according to the National Committee of Influenza guidelines. CBC and WBC differentiation were performed to detect leukopenia, anemia, or thrombocytopenia. Results: In this research 96 patients including 53 (55.2%) females and 43 (44.8%) males (mean age: 43.6±16.9) were studied. Mean WBC of patients were 6.9±2.62×103/cc and leukopenia was detected in 22 (22.9%) patients. The mean platelet count was 100×103/cc and 36 (37.5%) patients were thrombocytopenic. Mean hemoglobin levels were 6.1±1.12 g/dL and anemia was seen in 68 (70.8%) patients. There was no significant association between age, thrombocytopenia and leukopenia. Conclusion: In this study, thrombocytopenia, leukopenia, and anemia were detected in patients infected with H1N1 influenza.

Background and Objectives: Evidence suggests that underlying diseases increase the severity of influenza and lead to hospitalization or death. This study was conducted to determine the risk factors associated with hospitalization of patients in Afzalipour Hospital, Kerman, Iran during an outbreak of H1N1 influenza in December 2015. Methods: In this case-control study, the case group comprised 85 patients who were hospitalized for influenza and the control group included 51 patients who had influenza symptoms and were discharged after required evaluations and check-up. The data were collected from both groups on a daily basis for two weeks. For data analysis, descriptive analysis, logistic regression analysis, Lasso Regression, and likelihood ratio were used. Analysis was performed using the Stata version 12 and R software. Results: Among the variables examined, after removal of additional variables, 12 variables were introduced into the multivariate regression. The history of pulmonary disease and diabetes increased the odds of hospitalization following influenza by more than 11 (OR = 11.6, P. value = 0.003) and 9 times (OR = 9, P. value = 0.01), respectively. Conclusion: Underlying disease and factors play a major role in exacerbating the disease. Therefore, the health system should take the necessary preventive measures when outbreaks occur.

Background and purpose: H1N1 influenza circulate worldwide and affects the world population in case of pandemic. The aim of this study was to evaluate the awareness of urban family physicians in Mazandaran province, Iran about H1N1 influenza. Materials and methods: In a descriptive study, 373 urban family physicians were questioned. A standard questionnaire including different items were completed by participants. The items included epidemiology (7 questions), treatment (5 questions), virology and diagnosis (5 questions), clinical manifestations (6 questions), and prevention (4 questions) of H1N1 influenza. Data was then coded and analyzed in SPSS V18 applying Chi-square, t-test, and Fisher's exact test. Results: The participants were 47.5% females and 52.5% males. The levels of knowledge about H1N1 influenza were poor in 0.8%, fair in 11.3% and good in 60.3%. Also, 27.6% of the participants had excellent levels of knowledge on this type of influenza. The average scores of participants for epidemiology, virology and diagnostics, clinical manifestations, prevention, and treatment were 4.30, 3.38, 4.59, 2.79, and 3.67, respectively. The mean scores for knowledge in epidemiology and treatment were found to be higher in female physicians compared to those of their male counterparts. Our results indicated a direct correlation between experience and knowledge on virology, diagnosis, clinical symptoms, and prevention and treatment, while it was inversely related with knowledge on epidemiology of H1N1 influenza. Conclusion: This study showed a relatively high level of knowledge among urban family physicians in Mazandaran province about H1N1 influenza. But they are strongly recommended to participate in continues education programs that increase their awareness and enhance their knowledge.

Background and purpose: Influenza is a seasonal respiratory illness that affects all age groups and causes excess mortality. Identifying the clinical manifestations and complications could be of great value in preventing the flue pandemic. Recent H1N1 pandemic is associated with some unusual findings such as thrombocytopenia, leukopenia, and lymphopenia which are not reported in other types of Influenza. Herein we investigate the hematological manifestations of influenza patients. Materials and methods: This study included all patients with flu symptoms attending Sari Imam Khomeyni Hospital and Qaemshahr Razi Hospital, winter 2015. H1N1 influenza infection was confirmed by polymerase chain reaction from nasopharyngeal specimen received through nasopharyngeal swabs according to the National Committee of Influenza guidelines. CBC and WBC differentiation were performed to detect leukopenia, anemia, or thrombocytopenia. Results: In this research 96 patients including 53 (55.2%) females and 43 (44.8%) males (mean age: 43.6±16.9) were studied. Mean WBC of patients were 6.9±2.62×103/cc and leukopenia was detected in 22 (22.9%) patients. The mean platelet count was 100×103/cc and 36 (37.5%) patients were thrombocytopenic. Mean hemoglobin levels were 6.1±1.12 g/dL and anemia was seen in 68 (70.8%) patients. There was no significant association between age, thrombocytopenia and leukopenia. Conclusion: In this study, thrombocytopenia, leukopenia, and anemia were detected in patients infected with H1N1 influenza. [ABSTRACT FROM AUTHOR]

Background and purpose: H1N1 influenza circulate worldwide and affects the world population in case of pandemic. The aim of this study was to evaluate the awareness of urban family physicians in Mazandaran province, Iran about H1N1 influenza. Materials and methods: In a descriptive study, 373 urban family physicians were questioned. A standard questionnaire including different items were completed by participants. The items included epidemiology (7 questions), treatment (5 questions), virology and diagnosis (5 questions), clinical manifestations (6 questions), and prevention (4 questions) of H1N1 influenza. Data was then coded and analyzed in SPSS V18 applying Chi-square, t-test, and Fisher's exact test. Results: The participants were 47.5% females and 52.5% males. The levels of knowledge about H1N1 influenza were poor in 0.8%, fair in 11.3% and good in 60.3%. Also, 27.6% of the participants had excellent levels of knowledge on this type of influenza. The average scores of participants for epidemiology, virology and diagnostics, clinical manifestations, prevention, and treatment were 4.30, 3.38, 4.59, 2.79, and 3.67, respectively. The mean scores for knowledge in epidemiology and treatment were found to be higher in female physicians compared to those of their male counterparts. Our results indicated a direct correlation between experience and knowledge on virology, diagnosis, clinical symptoms, and prevention and treatment, while it was inversely related with knowledge on epidemiology of H1N1 influenza. Conclusion: This study showed a relatively high level of knowledge among urban family physicians in Mazandaran province about H1N1 influenza. But they are strongly recommended to participate in continues education programs that increase their awareness and enhance their knowledge. [ABSTRACT FROM AUTHOR]

Background & Objectives: Considering new pandemic attack with new emerging (H1N1) influenza virus, the study was designed for evaluating clinical and epidemiologic characteristics of patients in Imam Khomeini hospital, admitted with presumptive diagnosis of H1N1 influenza . In all of the patients clinical and paraclinical findings and outcome (including mortality rate and definitive diagnosis) were evaluated. Bed occupancy rate in infectious disease ward and ICU and also mean days of admission were calculated. Methods: This is a cross sectional study . All 118 patients with acute respiratory symptoms and possible diagnosis of emerging H1N1 influenza that had been admitted at least 24 hours in hospital from 20 October to 1 February 2009 were enrolled in the study. Data collection was done based on questionnaires, with a team other than researchers. The questionnaire included demographic data , clinical symptoms , laboratory findings , radiographic manifestations and outcome of patients. Data analysis was performed with SPSS software version16. Results: A total of 118 patients were studied: 71 patients ( 60.2%) were female and 47 patients ( 39.8%) were male. Mean ( ± SD) age of admitted patients was 33.81 ± 15.64 years old. The most of admitted patients were in age range of 15 to 30 years old. The most common findings in CXR were bilateral respiratory consolidations and the most common symptoms were fever, weakness and fatigue. About 12.7% of patients had diarrhea. Leukopenia (WBC < 4000) and leukocytosis (WBC > 10000) occurred respectively in 4.58% and 33.2% of cases . Nine patients (7%) were admitted in ICU. I n 21 patients (18%) RT-PCR test results were positive and three of these patients had been admitted in ICU. In patients admitted in ICU while their diagnosis was confirmed, mortality was 33%. 48.3% of patients had at least one predisposing medical condition . Total admission days were 577 days, consisting 519 days in infectious disease ward and 58 days in ICU. Average of hospitalization days per a patient was 4.88 days. Conclusion: Except epidemiologic clues, there was no pathognomonic sign or symptom to differentiate influenza H1N1 from other respiratory tract infections. High proportions of pregnant women, bilateral respiratory consolidations, and presence of diarrhea and leukopenia in considerable number of patients were the most important findings of the study.

Background: In 2009, the novel H1N1 virus pandemic appeared with the ability of transmitting from human to human. In our country, the epidemic occurred between 2009 and 2010. This study assessed the epidemiology of patients with H1N1 influenza and its risk factors, also, needing care in intensive care units, and the prevalence of death. Methods: In a cross-sectional study, all the patients with influenza H1N1 admitted to Al-zahra medical center (Isfahan, Iran) during the epidemic period were entered. Demographic characteristics, clinical symptoms, laboratory and radiological findings, and underlying diseases were recorded. The data were analyzed by chi-square, One-way ANOVA and t tests. Findings: 74 women and 76 men with H1N1 influenza were admitted. Fever (87%), cough (76%),and dyspnea (48.7%) were the most common clinical findings and lymphopenia (48.3%) was the most common paraclinical finding. 28% of patients needed ventilation support and 23 (15.3%) were died. The neurological symptoms (OR = 5.83), lymphopenia (OR = 2.87) and infiltration in the chest X-ray (OR = 1.67) were effective factors in increasing need for admission to the intensive care unit. The most prevalent risk factors for death were neurologic symptoms (OR = 17.04), abdominal pain (OR = 5.60), increased creatinine kinase (OR = 4.89), respiratory distress (OR = 3.67) and lymphopenia (OR = 2.27). Conclusion: According to our findings, neurological symptoms, lymphopenia, infiltration in the chest X-ray, abdominal pain, increased creatinine kinase (OR = 4.89), and respiratory distress are very critical sign and symptoms which should be carefully considered in patients with H1N1 Influenza [ABSTRACT FROM AUTHOR]

Background: Respiratory virus infections represent a major public health problem because of their worldwide occurrence, ease of spread in the community and considerable morbidity and mortality. They are one of the most common reasons for hospitalization of children under the age of six. In some cases, infection with two different viruses increase the severity of disease which lead to the hospitalization. Case presentation: Among 202 samples related to children under the age of six with respiratory infections, two dual infections of Adenovirus with other respiratory viruses with PCR test were detected. Conclusion: Mixed respiratory viral infections are sometimes associated with severe disease and recognition of coinfection is important. Dual infections of Adenovirus with respiratory syncytial virus (RSV) and Swine origin influenza A (H1N1) virus were demonstrated. The evidence showed that the co-infection of Adenovirus with swine origin influenza A (H1N1), has increased the severity of disease which lead to the hospitalization. [ABSTRACT FROM AUTHOR]