[Behavioral surveillance survey [BSS] among injection drug users [IDUs] in Zanjan-Iran]

Injection Drug Users [IDUs] include more than 69.9% of known HIV/AIDS cases in Iran. The most important causes of HIV among them are syringe sharing and high risk behaviours such as sexual practice with different partners. Since IDUs are hard to reach and there is little information about them, this behavioural survey conducted to explore Zanjan district.s injection drug users in relation to HIV/AIDS. In this descriptive-cross sectional study, 61 IDUs, inhabitants of Zanjan, were selected in non-random sampling by referring to the most probable sites and places of their presence. Data was collected using a standard Family Health Behavioral Surveillance Survey [BSS] questionnaire designed especially for IDUs. Mean duration of non injected and injected drug use was 12.1 +/- 5 and 4.5 +/- 3.5 years respectively, and age of the first injection was 24 +/- 5.4 years. The most frequently injected drug was Heroin [96.7%] and the most noninjected one was Cannabis [85.2]. 55.7% of IDUs injected 4 or more times per day, and 32.8% reported needle sharing. 100% of the subjects knew the role of used syringe in HIV transmitting. 44.3% had taken an HIV test, and 70.4% knew about their HIV status. The early age of starting drug injection, needle sharing, coverage of voluntary HIV testing in less than 25%, and unawareness of 1/3 of them about their HIV test status indicate the significance of priority and service delivery to this most high risk group

efficacy of combined levothyroxine plus liothyronine with levothyroxine alone in primary hypothyroidism: a randomized controlled trial

We conducted this controlled trial to investigate whether combined therapy with levothyroxine and liothyronine in primary hypothyroidism, would lead to improvements in general health, quality of life, psychological problems and metabolic changes. This study was a double blinded randomized control trial. Patients were invited to participate if they were between the ages of 18 and 60 years, and if they had been receiving treatment for primary hypothyroidism for at least 6 months, including a stable dose of levothyroxine for at least 3 months, and had normal serum thyroid hormone levels. Patients were randomized to receive combined levothyroxine plus liothyronine [patients in this group decreased their usual daily dose of levothyroxine by 50 microg and began taking 6.25 microg of liothyronine twice daily] or to continue their usual dose of levothyroxine. Treatment duration was 4 months. Weight, height, heart rate, blood pressure, total Cholesterol, LDL, HDL, Triglycerides, serum TSH, total T4, and total T3 levels were measured before and after of study. All patients completed the General Health Questionnaire -28 [GHQ-28] before and after the trial. Seventy-one participants were randomized into the 2 groups, and 60 completed the study. In the combined therapy group, serum T4 levels fell and serum T3 levels rose [P<.001], although both levels remained within normal limits. Serum TSH levels were similar in both groups at baseline and at 4 months. There were no differences between weight, heart rate, blood pressure and lipid profiles of two groups. For the GHQ-28, the overall score was similar but the anxiety/insomnia subscale was significantly higher [indicating worse psychological well-being] for combined treatment compared with T4 alone [P=0.037]. The only biochemical change was the expected rise in serum T3 levels and fall in serum T4 in the combined therapy group, because the blood samples were drawn only 1-2 hour after the morning dose of liothyronine. In conclusion, we found no evidence that combined T4/T3 replacement, resulted in improved well-being, general health, quality of life and lipid profile compared with T4 alone. T4 should remain the standard treatment for hypothyroidism