Prevalence of HIV infection and the correlates among homeless in Tehran, Iran

<p><b>OBJECTIVE</b>To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran, Iran.</p><p><b>METHODS</b>In 2007-2008, Tehran municipality stacked up 10672 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS (IRCHA) departments to conduct HIV infection prevalence surveys in homeless populations. The results were analyzed for associations with demographic information, family support, status of drug abuse and relation with family and friends.</p><p><b>RESULTS</b>Overall HIV prevalence was 1.7% (95% confidence interval 1.4-1.9). Factors independently associated with HIV infection included history of using drugs [AOR 8.15 (4.86-13.67)], older age [AOR 1.80 (1.08-2.99) for 40-55 yr], occupation [AOR 1.64 (1.19-2.24) for unemployed], and no relation with family [AOR 1.82 (1.30-2.54)].</p><p><b>CONCLUSIONS</b>This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless. Harm reduction programs should be expanded, particularly among homeless injection drug users.</p>

Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease

We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.

Diffuse pulmonary hemorrhage after fibrinolytic therapy for acute myocardial infarction in a cocaine abuser patient

We report a 45-year-old man with antroseptal myocardial infarction who developed bilateral basal alveolar infiltrates after initiating the fibrinolytic therapy. Although thrombolytic therapy with streptokinase is generally used in the course of acute myocardial infarction and has diminished morbidity and mortality, pulmonary hemorrhage is an uncommon, but a potentially life-threatening complication that should be regarded as one of the differential diagnoses of pulmonary infiltrates or dropping hemoglobin with no apparent bleeding site

Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

<p><b>OBJECTIVE</b>To identify the frequency of syphilis among Iranian HIV-positive patients.</p><p><b>METHODS</b>A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected.</p><p><b>RESULTS</b>Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis.</p><p><b>CONCLUSIONS</b>Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.</p>

Combination of probiotics and antibiotics in the prevention of recurrent urinary tract infection in children

We examined the preventive effect of probiotic and antibiotics versus antibiotics alone, in children with recurrent urinary tract infections [RUTI] in a preliminary randomized clinical trial. Between March 2007 and April 2011, children with the history of RUTI and unilateral vesicoureteral reflux [VUR] were randomly assigned to receive concomitant probiotic and antibiotics [Lactobacillus acidophilus and bifidobacterium lactis, 10[7]/ml, as 0.25 ml/kg three times a day regimen in addition to Nitrofurantoin, 1mg/kg daily [group I]. In group II, all children received conventional prophylactic antibiotics alone [Nitrofurantoin, 1 mg/kg daily]. Randomization was performed via using the random numerals table in a 1:1 manner with stratification by sex, age and grade of reflux. The urine examinations were done monthly and the incidence of UTI was evaluated in these two groups. Forty-one children [age: 8.3 +/- 3.1 years] in group I and 44 children [age: 8.0 +/- 3.0 years] in group II were compared. During the course of three years, 39% in group I and 50% of participants in group II experienced RUTIs [P=0.4]. Incidences of UTI - febrile and afebrile - reduced in both groups without any significant differences after two years of prophylaxis. Also, incidence of afebrile UTIs did not significantly differ [0.51 +/- 1.30 and 0.81 +/- 1.41 respectively, P=0.3]; however, the incidence of febrile UTIs in particular were lower in group I [0.00 +/- 0.00 versus 0.13 +/- 0.40, P=0.03] in the last year. The consumption of probiotic and antibiotics in children with RUTI is safe and more effective in reducing the incidence of febrile UTI in comparison to prophylactic antibiotics alone

Brucella infection in HIV infected patients

The purpose of this study was to assess the possible correlation between Brucella and HIV infections. Iran is a country where HIV infection is expanding and Brucellosis is prevalent. In the present study. 184 HIV infected patients were assigned and for all of them HIV infection was confirmed by western blot test. In order to identify the prevalence rate of Brucella infection and systemic brucellosis in these subjects, sera samples were obtained and Brucella specific serological tests were performed to reveal antibody titers. Detailed history was taken and physical examination was carried out for all of patients. 11 [6%] subjects had high titers but only 3 of them were symptomatic. Most of these subjects were injection drug user [IDU] men and one was a rural woman. Considering both prevalence rates of Brucella infection [3%] and symptomatic brucellosis [0.1%] in Iran, our HIV positive patients show higher rates of Brucella infection and systemic brucellosis. Preserved cellular immunity of participants and retention of granulocytes activity may explain this poor association; whereas other explanations such as immunological state difference and non-overlapping geographical distribution of the 2 pathogens have been mentioned by various authors