Counseling and harm reduction centers for vulnerable women to HIV/AIDS in Iran

Human immunodeficiency virus [HIV] is a public health challenge facing both developing and developed nations. Although injecting drug use is even the main route of HIV transmission in Iran, sexual route is rising gradually. Vulnerable women have been considered as important bridging population for driving HIV epidemics. To increase the access to vulnerable women, in 2007, 5 pilot centers were established in risky areas to deliver comprehensive services to women who themselves or their spouses are engaged in drug use, risky sexual behavior or have history of imprisonment. Management of Sexually Transmitted Infection, psychological counseling and harm reduction are provided by female staff. The aim of this study was to report the activities conducting in 2008. Registered information was used to assess the demographic characteristic, HIV/ AIDS related risk factors and services delivered to clients. Till March 2008, 442 clients have been admitted. Most of them [36.2%] had 25-34 years old. 14.3% were illiterate and 31% were totally jobless. The most prevalent risk factors were risky sexual behavior [27.1%] and non-injecting drug use [23.2%]. Injecting drug use was detected in 11.3% of attendees. Dividing clients according to marital status, risky sexual behavior was the main risk factor in unmarried [40.2%] and divorced [26.9%] but in married and widow ones, non-injecting drug use was the most [25.8% and 36.5% respectively]. Harm reduction [40.5%] and counseling [36.6%] were the most delivered services. Since vulnerable women play a critical role to spread HIV-epidemic to general population, increasing centers provide more access to this population

association between y chromosome microdeletion and recurrent pregnancy loss

To date, the role of male factor contributing in evaluation of spontaneous recurrent pregnancy loss [RPL] has been less investigated and there is discrepancy in the role of Y chromosome microdeltions in RPL. Therefore, the current study was designed to examine whether Y chromosome microdeletions were associated with RPL in an Iranian population. One hundred men from couples, experiencing three or more RPLs, and one hundred normal men from couples with at least one child and no history of miscarriages as control group were included. Genomic DNA was extracted from peripheral blood and tested for Y chromosome microdeletions in AZFa, AZFb and AZFc regions using two multiplex PCR. None of the men in the case and control groups had any microdeletions in the AZFa, AZFb and AZFc regions. It seems that Y chromosome microdeletion is not associated with recurrent pregnancy loss, therefore performing this test in Iranian couples with RPL is not recommended

Introducing a quantitative method to calculate the rate of primary infertility

In the previous studies, the rate of primary infertility was reported differently. It seems the main reasons are related to the different methods of data collection and information analysis. Therefore, introducing a precise method to determine the infertile couples and the population exposed to the risk of infertility is an important issue to study primary infertility. The proposed methodology for assessing primary infertility rate has been designed and applied by Avicenna Research Institute in a national survey. Sampling was conducted based on probability proportional to size cluster method. In this survey, after reviewing the former studies, the reproductive history was used as a basis for data collection. Every reproductive event was recorded with a code and a date in the questionnaire. To introduce a precise method, all possible events were considered thoroughly and for each situation, it was determined whether these cases should be considered in numerator, denominator or it should be eliminated from the study. Also in some situations where the correct diagnosis of infertility was not possible, a sensitivity analysis was recommended to see the variability of results under different scenarios. The proposed methodology can precisely define the infertile women and the population exposed to the risk of infertility. So, this method is more accurate than other available data collection strategies. To avoid bias and make a consistent methodology, using this method is recommended in future prevalence studies

[Analysis of vitamin D levels in patients with rheumatoid arthritis and its relation with the disease status]

Vitamin D is an important factor for calcium hemostasis, and it is responsible for immune system regulation and lowering the risk of inflammatory disease. The aim of this descriptive study was to evaluate the vitamin D level in patients with rheumatoid arthritis [RA] and analyze its possible relation with the severity or the disease. This cross sectional study was performed on 135 patients who met the criteria for rheumatoid arthritis. Data on vitamin D levels from 224 people whom were referred to the Iranian Rheumatism Center laboratory but had turned negative for RA was used as control. Vitamin D levels lower than 30 ng/ml wereconsidered as deficiency, and levels lower than 10 ng/ml were characterized as severe deficiency. Disease status was measured by DAS28 and calculated using the related software. The majority of the patients [82.8%] were female. The mean age of the patients, whom included an 82.8% female participants, was 46.9 years, with a mean disease duration of 9.3 years. The average DAS28 was calculated as 3.47, with an average vitamin D level at 35.9 ng/ml. Vitamin D deficiency and severe deficiency were seen in 59.3% and 8.9% of the patients, respectively. We found no significant relation between the vitamin D levels and disease status. Vitamin D deficiency is common in patients with rheumatoid arthritis but it is does not appear to have a significant relation to the disease status/severity

association between sporadic Alzheimer's disease and the human ABCA1 and APOE gene polymorphisms in Iranian population

Apolipoprotein E [APOE], which its epsilon4 allele has been reported as a risk factor in late onset Alzheimer's disease [AD], is the main cholesterol carrier in the brain. ATP-binding cassette transporter A1 [ABCA1] gene on chromosome 9, which has been known by genome-wide AD linkage study, has an important role in cellular cholesterol efflux. This study determines the association between sporadic AD and the human ABCA1 and APOE gene polymorphisms in Iranian population. 154 AD cases and 162 control subjects from Iranian population were genotyped for APOE genotypes and ABCA1 polymorphism [R219K]. The frequency of epsilon2epsilon3 genotype was higher in control subjects comparing AD patients but was not significant [13% versus 5.8%] and epsilon3epsilon4 genotype frequency was significantly higher in AD cases comparing with control subjects. APOE-epsilon2 allele frequency in cases was lower than control subjects but this difference was not significant [4.5% versus 8%]. Individuals carrying epsilon4 allele, developed AD 6.5 times more than non-carriers [OR=6.52, 95%CI=2.63-16.17]. There was no significant association between ABCA1 polymorphism and AD. Unlike other studies, R219K polymorphism was not dependent on gender and APOE-epsilon4 allele and there was no association between APOE and ABCA1 in AD patients compared to controls

Association between alzheimer's disease and apolipoprotein E polymorphisms

Alzheimer's disease as a neurodegenerative disorder is the commonest type of dementia. A growing number of genes have been reported as the risk factors, which increase the susceptibility to Alzheimer's disease. Apolipoprotein E [APOE], which its 4 allele has been reported as a risk factor in late onset Alzheimer's disease [AD], is the main cholesterol carrier in the brain. The main goal of this study was to assess the role of APOE genotypes and alleles in AD in Iranian population. This study was performed in Tehran, Iran from 2007 to 2008. Totally, 154 AD cases and 162 control subjects from Iranian population were genotyped for APOE using PCR method. Genotype and alleles frequencies for APOE were calculated and compared between AD case and control subjects by epsilon 2 or Fisher's exact test. Type one error assumed less than 0.05. The frequency of epsilon 2 epsilon 3 genotype was significantly higher in control subjects than AD patients was [13.5% versus 5.2%, P<0.05] and epsilon 3 epsilon 4 genotype frequency was significantly higher in AD cases compared with control subjects. APOE-epsilon 2 allele frequency in cases was lower than that of control subjects but this difference was not significant [4.2% versus 7.7%]. It seems that individuals carrying epsilon 4 allele, develop AD 6.5 times more than non-carriers do [OR=6.566, 95% CI=2.89-14.92]. It has been reported that epsilon 4 allele acts in dose-age-dependent manner but we have shown that the risk of developing AD in male APOE-epsilon 4 allele carriers is higher than that of female epsilon 4 carriers

Comparing the combination effect of propofol-ketamine and propofol-alfentanil on hemodynamic stability during induction of general anesthesia in the elderly

Propofol [Diprivan], a modern intravenous hypnotic drug, produces a reduction in both cardiac index [CI] and mean arterial pressure [MAP] due to its sympatholytic activity. S-Ketamine [Ketanest], a potent analgesic, in contrast, causes an increase in both CI and MAP due to its sympathomimetic activity. This study was performed to compare the combination effects of propofol-ketamine and propofol-alfentanil on hemodynamic stability during induction of general anesthesia. In a prospective study, 100 patients over 60 [ASA I, II] scheduled for elective lower abdominal interventions were randomly divided into two groups. For induction of general anesthesia, after injection of midazolam, the first group [A] received alfentanil and propofol and the second group [B] received S-ketamine and propofol. Each group received atracurium as muscle relaxant. Blood pressure [BP] and heart rate [HR] were measured before and 1 and 5 minutes after induction of anesthesia. The increase in HR and decrease in MAP were statistically significant in both groups 1 and 5 minutes after general anesthesia. The increase in HR and decrease in MAP were significantly more in Group A, 1 and 5 minutes after general anesthesia. The dose of S-ketamine administered during induction of general anesthesia may not be enough to neutralize the cardio-depressant effect of propofol. A better hemodynamic activity was observed in Group B compared to Group A due to partial neutralization of the opposing action

Accuracy of CT scan in detection of benign or malignant nature of solitary pulmonary nodules in comparison with pathological results-A prospective study

Solitary Pulmonary Nodule [SPN] is one of the most common diagnostic problems in chest radiology because differentiation between benign and malignant nature of the lesions based on radiologic pictures may be difficult and sometimes impossible. Nowadays, CT scan is the most accurate imaging modality for diagnosis and characterization of pulmonary nodules. In this study, 131 patients were included in whom Preliminary chest x-ray revealed SPN, chest CT scan was the next imaging investigation in these patients. Chest CT Scan confirmed SPN in 103 patients. Of these patients, Fine Needle Aspiration [FNA] and surgical resection of the nodule were taken place in 69 and 27 patients respectively. Pathological results compared with CT scan findings. Considering CT characteristics of the lesions, results were in favor of malignancy in 27 patients and in other 61 patients, CT scan findings were consistent with benign process. Mentioned data disclosed sensitivity and specificity of CT scan in prediction of malignant SPN 81/8% and 86/3% respectively. CT scan as used in this study could be useful for determining benign or malignant nature of solitary pulmonary nodules. Rate of enhancement in the lesions following IV administration of contrast agent is the most important criterion to differentiate benign and malignant lesions

Trends in nested case- control studies as compared to case- control and cohort designs, 1996- 2005

This investigation was prompted by the growing importance of nested case-control studies and the increasing frequency with which they are done in epidemiologic research. After a brief explanation of nested case-control studies, we evaluate the trends in research methodology over the last decade, especially with regard to cohort, case-control, and nested case-control designs. Data for this study were extracted from the PubMed database, using these keywords: Nested Case-Control, Risk-Set Sampling and Density Sampling. The search was confined to the 10-year period from 1996 to the end of 2005. As for other methodologies, we used keywords Cohort and Case-Control for a search over the same time period. The search itself was performed on April 25, 2006. We found 201 1 articles reporting nested case-control studies. There were 95 such articles in 1996; the number had increased to 289 in 2005. Case-control and cohort designs accounted for 68456 and 60479 articles, respectively. The number of case-control articles rose from 4378 in 1996 to 10270 in 2005, while that of cohort articles increased from 2981 to 9771 over the same period. The number of cohort and nested case-control articles followed similar upward trends over the last decade and their rate of increase was greater than that of simple case-control articles

Retrobulbar anesthesia with or without adrenaline in extracapsular cataract extraction

This study aimed to examined the influence of adrenaline in retrobulbar anesthesia on examined the influence of adrenaline in retrobulbar anesthesia on the preoperative IOP and on position of the lens-iris diaphragm during extracapsular cataract extraction [ECCE]. The effect of adrenaline on akinesia, analgesia and the frequency of complications was also studied. 74 patients with cataract underwent a planned ECCE. They were randomly divided into 2 groups: Group I receiving retrobulbar anesthesia with adrenaline and group II without adrenaline. The results revealed that group I had the lowest mean IOP after the retrobulbar injection [P <0.05]. They required shorter time of digital bulbar massage to reduce tension before surgery [P <0.01], they also appeared to have a deeper anterior chamber during the 1st part of surgery. The duration of postoperative analgesia was significantly prolonged in patients receiving adrenaline. The use of adrenaline as an adjunct to the retrobulbar anesthetic solution is beneficial in ECCE