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Introduction: Cardiac disorders are common in patients with chronic obstructive pulmonary disease (COPD). They worsen shortness of breath and physical capacity and reduce the quality of life. Ultrasound assessment of cardiac function could contribute to assessing the severity of the disease. This study aimed to assess the prognostic significance of echocardiographic parameters on the rate of exacerbations and mortality. Materials and methods: This was a prospective study of patients with COPD without exacerbation in the previous 1 month. Patients over 40 years of age, current or former smokers with more than 10 pack-years of smoking, and postbronchodilator FEV1/FVC < 0.7 were included. All patients underwent two-dimensional transthoracic Doppler echocardiography at rest by an experienced cardiologist. Echocardiographic parameters were evaluated for prognostic significance on a composite endpoint of moderate and severe exacerbations and death for 1 year. Data from postbronchodilator spirometry, symptoms, quality of life, and demographic and clinical information were also collected. Results: A total of 96 patients were analyzed with a mean FEV1 of 55.8%. A total of 64 patients (67%) reached the composite endpoint. A significantly higher proportion of patients with deceleration time deviations (86.2 vs. 58.2%, p = 0.0055) and increased septal thickness (55.6 vs. 24.6%, p = 0.0099) reached the primary endpoint at one-year follow-up. Echocardiographic disorders showed a correlation with the quality of life, but not with lung function. Conclusion: Non-invasive assessment of cardiac function by echocardiography could be included in the complex assessment of disease severity in COPD patients.

X-linked agammaglobulinemia (XLA), characterized by a profound deficiency of B lymphocytes, is caused by mutations in the gene encoding Bruton tyrosine kinase (Btk).. XLA patients have a susceptibility to viral infections. In this report, we present a 45-year-old man with known XLA, with about a 2-week history of fever, chills, diarrhea and vomiting. He was diagnosed with COVID-19 infection, which was confirmed by a real-time reversetranscriptase- polymerase chain reaction. The antiviral drugs, antibiotics, and interferon-beta were administered to him. Unfortunately, the patient passed away after 5 days. During an epidemic of infectious diseases, the best strategy to overcome the potential challenges of treating XLA may be prevention. Early detection of biomarkers such as D-dimer and IL-6 might be more helpful for initiating more aggressive therapy and decreasing the duration of illness in these patients.

Introduction The various cutaneous manifestations have lately appeared in the setting of COVID‐19. Psoriasis flare‐ups have been reported during a COVID‐19 infection. Case presentation We present a case of a 32‐year‐old woman with COVID‐19 who presented with generalized pustular psoriasis. She received oral prednisolone, hydroxyzine, and topical clobetasol. The patient received follow‐up two weeks later and found that her lesions were favorably desquamating. Methods The PubMed, SCOPUS, and ISI Web of Science databases were thoroughly searched for English studies reporting psoriasis flare‐ups following SARS‐CoV‐2 infection. Ten case reports/series were included after screening. Conclusions Our case report brings awareness to clinicians for the possible cutaneous manifestation of COVID‐19, which should be considered part of the differential diagnoses.

Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

BACKGROUND: This study was aimed to investigate the risk factors for mortality in patients with COVID-19. METHODS: For this retrospective cohort study, we included 121 deceased and 436 discharged cases with COVID-19 in Babol, Northern Iran. The cases were between March 1 to April 1, 2020. RESULTS: Multivariate Poisson regression analysis revealed that older age (aRR: 1.03, 95% CI: 1.01, 1.05, p < 0.001), hospital length of stay (aRR: 0.94, 95% CI: 0.90, 0.97, p = 0.003), ICU admission (aRR: 4.34, 95% CI: 2.95, 6.37, p < 0.001), cerebrovascular disease (aRR: 1.96, 95% CI: 1.20, 3.19, p = 0.007), ventilator-associated pneumonia (VAP) (aRR: 2.09, 95% CI: 1.22, 3.55, p = 0.006), septic shock (aRR: 2.98, 95% CI: 1.44, 6.19, p = 0.003), acute respiratory distress syndrome (ARDS) (aRR: 3.80, 95% CI: 2.28, 6.31, p < 0.001), acute kidney failure (AKF) (aRR: 1.45, 95% CI: 1.12, 3.76, p = 0.021), acute heart failure (AHF) (aRR: 1.63, 95% CI: 1.01, 2.62, p = 0.043) and lymphocyte count (aRR: 3.01, 95% CI: 1.99, 4.57, p < 0.001) were associated with mortality. CONCLUSION: Findings showed that elderly with comorbidities such as cerebrovascular diseases had an increased risk of death. Some complications such as: pneumonia, septic shock, ARDS, AHF, and AKF played crucial roles as well death (Tab. 2, Ref. 25).

Refereed/Peer-reviewed Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a crucial step in ending the current worldwide pandemic. However, several particularly vulnerable groups in the population were not included in sufficient numbers in coronavirus disease 2019 (Covid-19) vaccine trials. Therefore, as science advances, the advice for vaccinating these special populations against Covid-19 will continue to evolve. This focused review provides the latest recommendations and considerations for these special populations (i.e., patients with rheumatologic and autoimmune disorders, cancer, transplant recipients, chronic liver diseases, end-stage renal disease, neurologic disorders, psychiatric disorders, diabetes mellitus, obesity, cardiovascular diseases, chronic obstructive pulmonary disease, human immunodeficiency virus, current smokers, pregnant and breastfeeding women, the elderly, children, and patients with allergic reactions) using the currently available research evidence.

Několik studii ukazalo, že infekcni endokarditida způsobena bakteriemi kmene Enterococcus faecalis je třetim hlavnim zdrojem infekcni endokarditidy (IE). Kromě toho existuje několik důkazů, ktere svědci o vztahu mezi enterokokalni IE a kolorektalnim karcinomem (CRC). Uvadime kazuistiku pacienta s infekcni endokarditidou způsobenou bakteriemi kmene Enterococcus faecalis spojenou s CRC. Jednasedmdesatiletý muž měl horecku, dyspnoe, ortopnoe, kasel, mirnou hemoptýzu, intermitentni rektoragii, blede spojivky, "jemne praskani" a typický zvuk uměle chlopně. Byla mu diagnostikovana bakteriemie vyvolana Enterococcus faecalis a nasledně endokarditida. Kolonoskopie byla take provedena a uvaděla, že ma velký obstrukcni maligni vřed v hepaticke flexuře. Biopsie odhalila adenokarcinom. Kolorektalni chirurgický tým provedl parcialni kolektomii. Kromě toho byl pacient lecen s endokarditidou. Je zdůrazněn význam kolonoskopickeho screeningu u pacientů s infekci E. faecalis a endokarditidou, jehož cilem je vyloucit diagnozu CRC.

Introduction Human brucellosis, the most prevalent zoonotic disease worldwide, is a systemic infection which can involve several organs. Among musculoskeletal complaints, spondylitis is the most frequent complication of brucellosis and primarily affects the lumbar and thoracic vertebrae. The involvement of the cervical spine is infrequent. Case report This case report concerns an unusual case of cervical spine spondylitis with an epidural abscess due to Brucella in a 43-year-old man. The diagnosis was based on the patient being domiciled in an endemic region, his symptoms and his occupation. Clinical outcomes improved following antimicrobial therapy of rifampin, doxycycline, and gentamycin, and were confirmed radiologically. Conclusion Early diagnosis and treatment are crucial for these patients. The timely commencement of medical treatment can help prevent surgery.

The novel coronavirus disease 2019 (COVID-19) is a causative agent of severe lower respiratory tract infection in patients. Since its discovery in December 2019, COVID-19 has spread to five continents and to this date, affected approximately 6,260,000 people. COVID-19 patients typically present with symptoms related to the respiratory system while neurological manifestations have scarcely been reported. Neurological presentations of COVID-19 infection are classified into two groups: CNS symptoms and peripheral nervous system (PNS) symptoms. CNS symptoms include headache, dizziness, loss of consciousness, convulsion, ataxia and acute cerebrovascular disease. The PNS symptoms consist of hypoplasia, hyposmia, hypogeusia and neuralgia. The association between COVID-19 and neurological problems needs further clarification and warrants detailed microbiological and pathological studies to better understand the virus and its impact on the brain and nervous system.

Seasonal Influenza can cause cardiovascular complications. Therefore, this study aimed to investigate recent influenza-like illnesses (ILI) in acute myocardial infarction (AMI) patients compared to other hospitalized patients as the control group during the cold season in the north of Iran. This retrospective case-control study included 300 patients (150 AMI patients and 150 controls) aged ≥ 50 years hospitalized for acute myocardial infarction (AMI) or other conditions between September 22, 2019, and March 15, 2020. Patients in each group were frequency-matched for gender and age range. The primary exposure was a recent ILI (fever ≥ 37.8°C, cough, and sore throat) in the past month. The patients’ mean age was 64.42 ± 9.47 years, with a range of 50-94 years. Forty-five (15%) patients had diseases that met the ILI criteria. The AMI group patients significantly reported more ILI than controls (adjusted OR: 3.04, 95% CI: 1.02 to 9.09, p < 0.001). On the other hand, patients who received the influenza vaccine were significantly less likely to have an acute myocardial infarction than those who did not receive the vaccine (adjusted OR: 0.02, 95% CI: 0.001 to 0.38, p = 0.006). In conclusion, the present study demonstrates that ILI can significantly increase the risk of AMI. Also, it was confirmed that Influenza vaccination could significantly reduce the risk of AMI.

Human papillomavirus (HPV) is one of the well-known causes of cervical cancer and one of the most prevalent sexually transmitted diseases (STDs). Since cervical cancer is one of the most common causes of morbidity and mortality in women, this study was performed to investigate students’ knowledge and attitudes in Babol University of Medical Sciences, Northern Iran, towards genital warts. This cross-sectional study assessed the perception and attitudes of 385 students at Babol University of Medical Sciences using a preconceived questionnaire. The data collection tool used in this study was a questionnaire that was confirmed to be valid and reliable. The participants’ mean age was 23.70 ± 3.27 years, with a range of 20-50 years. Evaluation of these students’ level of general information about HPV showed that 7 (1.8%) students had inadequate general information, 34 (8.8%) had moderate knowledge, and 344 (89.4%) had good general knowledge in this setting. There was also a significant association between students’ general knowledge of HPV and their field of study. Based on the present study results, the knowledge of the majority of Babol University of Medical Sciences students about genital warts was in a good range, and their knowledge about HPV routes of transmission was of moderate level. Moreover, the majority had an appropriate attitude to interact with people infected with HPV.

On December 31, 2019 novel Coronavirus (SARS-CoV-2) is the strain of Coronavirus that causes Coronavirus disease 2019 (COVID-19) It was initially reported from Wuhan, China This novel virus causes atypical clinical presentations that differs from other viral pneumonias;in fact, some clinical aspects of infection are not cleared today We present the case of a 69-year-old man with a 2-week history of dyspnea and hemoptysis He was diagnosed with COVID-19 infection, confirmed by real-time reverse-transcriptase-polymerase chain reaction On day 11 postadmission, the case's condition improved significantly, with his oxygen saturation rising and lymphopenia subsiding His dyspnea gradually decreased in severity;furthermore, hemoptysis was controlled after treatment This case indicates the complexity and variety of pneumonia complications caused by COVID-19 infection We must have a high clinical suspicion in management of suspected cases especially in patients with novel clinical presentations such as our case in a pandemic Thus, hemothorax due to viral lung parenchymal destruction can be a complication of COVID-19 pneumonia

Background and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were P =0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P Conclusions: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.

Background. In December 2019, China has experienced an outbreak of novel coronavirus disease 2019 (COVID-19). Coronavirus has now spread to all of the continents. We aimed to consider clinical characteristics, laboratory data of COVID-19 that provided more information for the research of this novel virus. Methods. We performed a retrospective cohort study on the clinical symptoms and laboratory findings of a series of the 100 confirmed patients with COVID-19. These patients were admitted to the hospitals affiliated to Babol University of Medical Sciences (Ayatollah Rohani, Shahid Beheshti and Yahyanejad hospitals) form 25 February 2020 to 12 March 2020. Results. Nineteen patients died during hospitalization and 81 were discharged. Non-survivor patients had a significantly higher C-reactive protein (CRP) (MD: 46.37, 95% CI: 20.84, 71.90; P = 0.001), white blood cells (WBCs) (MD: 3.10, 95% CI: 1.53, 4.67; P < 0.001) and lower lymphocyte (MD: –8.75, 95% CI: –12.62, –4.87; P < 0.001) compared to survivor patients Data analysis showed that comorbid conditions (aRR: 2.99, 95% CI: 1.09, 8.21, P = 0.034), higher CRP levels (aRR: 1.02, 95% CI: 1.01, 1.03, P = 0.044), and lower lymphocyte (aRR: 0.82, 95% CI: 0.73, 0.93, P = 0.003) were associated with increased risk of death. Conclusions. Based on our findings, most non-survivors are elderly with comorbidities. Lymphopenia and increased levels of WBCs along with elevated CRP were associated with increased risk of death. Therefore, it is best to be regularly assessed these markers during treatment of COVID-19 patients.

Guillain–Barré syndrome (GBS) is an inflammatory disorder and an acute immune-mediated demyelinating neuropathy that causes reduced signal transmissions, progressive muscle weakness, and paralysis. The etiology of the syndrome still remains controversial and uncertain. GBS can be initiated and triggered by respiratory tract infections such as influenza, and intestinal infections such as Campylobacter jejuni. In addition, there is considerable evidence suggesting links between influenza vaccination and GBS. As reported previously, the incidence of GBS in individuals receiving swine flu vaccine was about one to two cases per million. Despite the influenza vaccine efficacy, its association with an immune-mediated demyelinating process can be challenging as millions of people get vaccinated every year. In this review we will discuss the association between influenza infection and vaccination with GBS by focusing on the possible immunopathological mechanisms.

In the current study, we investigated the risk factors for tuberculosis in patients admitted to the Ayatollah Rouhani Hospital in Babol, north of Iran. This cross-sectional study was conducted on 207 patients with proven tuberculosis during the years 2008-2015. Demographic data such as age and sex, smoking, history of underlying illness, illness symptoms, and laboratory results were collected and analyzed at a significant level of less than 0.05. From 207 patients, 136 were male (65.7%), 71 were female (34.3%), and 76 of them (37.3%) were smokers. It is notable that most patients (29.5%) were over the age of 71. The relation between age profile and being tuberculosis has been studied, but the co-relation was found to be not significant. The most common complaint has been coughing (60.9%). While investigating underling diseases, the most common illness has found to be Diabetes (11.3%). Based our finding, there was a significant relationship between gender and smoking with tuberculosis. Accordingly, as smoking is one of the risk factors for tuberculosis, smokers and non-smokers should be informed that smoking carries the risk for tuberculosis. Such a program should be particularly addressed to males.

Sarcoidosis is a granulomatous condition with unidentified etiology. This disease should be considered in differential diagnosis if non-caseating granulomas is noted in biopsies, because numerous cases presented with no clinical symptoms. Although the lung is the most common organ involved in the disease, there also is an extra-pulmonary form (

We performed an age matched case-control study of incident epileptic patients to assess the relationship between Toxoplasma gondii seropositivity and epilepsy. Cases were 94 newly diagnosed patients (mean age, 36.7 ± 15.9) with unprovoked convulsive epilepsy of unknown etiology and controls were 88 healthy individuals (mean age, 37.5 ± 17.1) with no history of epilepsy or neurological disorders. Sera of all subjects were examined for anti-Toxoplasma IgG antibodies using commercially enzyme-linked immunoassays. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using univariate analysis and logistic regression, adjusted for potential confounders. The prevalence of anti-Toxoplasma IgG antibodies in epileptic patients (68.1%; 95%CI, 57.6-77.3%) was significantly higher than healthy controls (47.7%; 95%CI, 36.9-58.6%), indicating a significant relationship between Toxoplasma infection seropositivity and epilepsy (adjusted OR, 2.58; 95%CI, 1.16-5.72; P value

The COVID-19 has a wide range of symptoms. This novel infectious disease may also trigger a vast range of neurological involvements. The current report describes a case of COVID-19 complicated with Bell’s palsy. A 64-year-old woman with diabetes was admitted due to abrupt left hemifacial weakness. On examination, her left hemifacial expression ability was impaired so that her face seemed asymmetrical during smiling, and numbness around the left nasolabial fold was detected. Furthermore, her ability to wink was impaired, and her eyebrow drooped. A brain computed tomography (CT) scan did not show any abnormalities. A lung CT scan was performed, which demonstrated bilateral ground-glass opacity (GGO), along with RT-PCR results indicative of COVID-19. A diagnosis of Bell’s palsy in the setting of COVID-19 infection was made. She received antiviral agents and corticosteroids. At two week follow-up, her symptoms had improved. During the COVID-19 epidemic, any newly occurred neurological involvement raises the suspicion of COVID-19 infection.

SARS-CoV-2 is the causative agent of COVID-19. Since its outbreak in December 2019, COVID-19 has swept the globe. By 17 July 2020, the World Health Organization (WHO) had confirmed 13 119 239 cases and 573 752 deaths, and the numbers are still rising. Current evidence shows that COVID-19 is lower than severe acute respiratory syndrome and Middle East respiratory syndrome in terms of severity and mortality risk, although the infections are particularly more severe in patients with underlying medical conditions. The bulk of COVID-19 patients had close contact with confirmed cases, but an exact origin and specific transmission for COVID-19 are still unknown. As there is no approved antiviral treatment for COVID-19 infection, proper prevention and control practices are essential to control the infection. To have an insight view of COVID-19, we summarized and compared the etiology, clinical manifestations, diagnosis, treatment, and prevention measures of COVID-19, severe acute respiratory syndrome, and Middle East respiratory syndrome.

Cytomegalovirus (CMV) can cause significant inflammation. Besides, it is an important cause of pancreatitis in organ transplantations. We report a case of CMV pancreatitis in a 48-year-old male kidney transplant recipient who was admitted with elevated amylase (3 337 U/L) and lipase (1 160 U/L) enzymes, and abdominal pain. CMV infection was tested by reverse transcription polymerase chain reaction and the result was positive. CMV viremia was successfully cleared with ganciclovir. Then the absence of some of more noticeable clinical symptoms of pancreatitis may not be a decisive reason not to rule out the disease in transplanted cases.

Rationale: Gastropericardial fistula is a rare condition in which the patient presented with chest pain, dyspnea, tachycardia, pneumo/hydropericardium, or pericarditis. Alcohol intake or previous history of gastroesophageal surgery made the patient susceptible to fistula formation. Patient concerns: An 80-year-old male complained of sudden onset of dyspnea and respiratory distress. Nausea, hematemesis, and constipation were noted on clinical examination. Diagnosis: Herniation of the gastric fundus and massive pneumopericardium due to formation of fistula in the lesser curvature. Interventions: Urgent surgery was performed. Outcomes: The patient was discharged without any complication. Lessons: Although the lethal form of this condition is rare, gastroepicardial fistula should be included in the differential diagnosis workup of cases with stomach cardia and fundus ulceration.

Rationale: Strongyloides stercoralis (S. stercoralis) is an intestinal nematode with a complicated life cycle that can involve the gastrointestinal system. Infected patients are generally asymptomatic; but if symptomatic, the symptoms will include skin rash, respiratory and gastrointestinal symptoms like abdominal pain, diarrhea, nausea and vomiting. Patient concerns: A 77-year old man presented with edema of the lower extremities and insignificant tenderness in the epigastric region. Diagnosis: The histopathology of gastric tissue showed severe inflammation and multiple ulcers in the cardia, antrum and proximal duodenum. A large number of rhabditiform larvae of S. stercoralis along with tissue hyperemia and infiltration of lymphoplasma cells, eosinophils, and neutrophils were found. Intervention: Treatment with albendazole. Outcome: Despite the albendazole treatment, the patient’s condition deteriorated and eventually died because of a sepsis-like syndrome. Lesson: Physicians should remain alert to the urgency due to threadworm, especially among the elderly people and immunosuppressed cases; and should ensure accurate diagnosis, suitable treatment and careful follow-up of these cases.

Objective: To investigate antibiotic resistance pattern of ventilator-associated pneumonia (VAP) generating microorganisms, and quantitative culture and determining antibiotic sensitivity. Methods: This cross sectional study was performed on 50 patients suffering from VAP in intensive care unit of Ayatollah Rouhani Hospital, Babol, Iran during 2014–2015. VAP was probable for them based on clinical signs and the criteria of Clinical Pulmonary Infection Score standards. Lower respiratory samples were given under bronchoalveolar lavage and quantitative culture was done on them. Afterwards by microdilution method, minimal inhibitory concentration based on respective microorganisms, considering clinical pulmonary infection score were determined. Results: From 50 investigated samples in this study, the most common microorganisms were Acinetobacter baumannii (A. baumannii) (70%) then Pseudomonas aeruginosa (12%), Staphylococcus aureus (8%) and Klebsiella pneumonia (3%). In our study A. baumannii showed approximate 100% resistance to all antibiotics, in a way that A. baumannii resistance to imipenem and meropenem and piperacillin/tazobactam each was 97.1%. The most resistance of Pseudomonas aeruginosa was 66.7% to each cefepime and ceftazidime and clavulanate/ticarcillin. Staphylococcus aureus showed 75% resistance to nafcillin, cloxacillin and resistance in case of vancomycin was not seen. Conclusion: In current study, A. baumannii had the most prevalence among VAP and this species is resistant to most of antibiotics. Using ceftazidime, cefepime and clavulanate/ticarcillin, in treatment of the patients suffering VAP is not reasonable.

Leptospirosis is a zoonosis that common in warm and tropical regions with global spread and it is an occupational disease. The aim of recent study was to evaluate the clinical and Para clinical findings of leptospirosis patients in Babol, northern of Iran. In this cross-sectional study, 118 patients with high suspicion to leptospirosis admitted to hospitals of Babol University of Medical Sciences, Babol, Iran, during 2009 -2011. Thirty one cases with positive finding (IFA) were enrolled as definitive Patients. Clinical and Para clinical data for all patients were recorded. The mean age of the confirmed ‎patients (male: 71%, rural: 90.5%) was 48.5 years (range 18-80 years old). The commonest chief complaints were fever (71%) and ichter (19%) and among the clinical features of them fever (90.5%), gastro intestinal signs (80.5%), ichter (71%) and headache(68%) was the most prevalent ones. Weil's syndrome occurred in 10 (32%) patients. Thrombocytopenia and leukocytosis were noticed in 80.5% and 42% of the patients respectively. Transaminases in 80.5% of cases were above the normal upper limit. Based on current study, the most of leptospirosis patients were farmers and presented in hot seasons. The commonest clinical and laboratory pattern of this disease in our region was fever, ichter, myalgia and headache in conjunction with Mild elevations in levels of transaminases and thrombocytopenia that can be used as a good marker in early clinical diagnosis and treatment.

Leptospirosis is a common disease between humans and animals. Identifying common serogroups and comparing different clinical symptoms among them can help in finding the clinical pattern associated with pathogen serogroupes of leptospirosis. Therefore, the purpose of this study has been to investigate the common serotypes of the infection and their clinical symptoms in northern Iran. This cross-sectional study was carried out in educational hospitals of Babol University of Medical Sciences during the years 2011- 2014. Subjects with clinical findings consistent with leptospirosis were included in the study. According to the standard MAT guidelines, the titre >=1: 200 was considered positive. Then, the patients identified by serogroup separation, were examined and compared clinical symptoms. Among 6o patients with primary diagnosis of leptospirosis in this study, 35 of them proved to be infected to the disease. The most common serogroups were serjoe (40%) and icterohemorrhagia (31.4%). Autumnalis (22.8%), grippotyphosa (11.4%), canicola (8.6%), and pomona (2.8%) were included the subsequent serogroups. The highest frequency of fever (28%) and gastrointestinal manifestations (36%) were observed in icterohemorrhagia and the highest icterus (30%) was found in serjoe serogroup. In this study, serjoe serogroup with fever and icterus, and then icterohemorrhagia with fever and gastrointestinal symptoms were introduced as the most common serogroups of Leptospirosis. Also the rarest serogroups were canicola and pomona.