High prevalence of HCV coinfection in HIV-infected individuals in Shiraz, Islamic Republic of Iran.

We carried out a cross-sectional survey in Shiraz to determine the prevalence of hepatitis C virus (HCV) in 1 444 individuals infected with human immunodeficiency virus (HIV). We also determined the risk factors for this coinfection. Demographic and behavioural data were obtained using a standard questionnaire. The prevalence of HIV-HCV coinfection was 78.4% (95% CI: 76.3-80.5). Intravenous drug use (OR = 7.2; 95% CI: 4.9-10.6), imprisonment (OR = 6.9; 95% CI: 4.6-10.4), tattooing in prison (OR = 2.61; 95% CI: 1.4-4.8), tattooing out of prison (OR = 2.0; 95% CI: 1.3-3.1) and age (OR = 1.02 with increasing each year of life; 95% CI: 1.0-1.04) were significantly associated with HCV-HIV coinfection. Prevalence of HCV-HIV coinfection is high in Shiraz. Intravenous drug use and imprisonment are the main risk factors for this coinfection. Therefore, serious implementation of HIV and HCV testing, education, prevention, care and treatment programmes and evaluation of harm reduction programmes in prisons are very important.

Graft survival rate following renal transplantation in diabetic patients.

Diabetic nephropathy is the most common cause of kidney failure needing dialysis in most countries of the world. Kidney disease occurs in one-third of diabetic patients, and significantly increases the mortality rates and treatment costs. The aim of the present study was to investigate the survival rate and to determine factors that influence survival among diabetic patients who underwent transplantation at the Shiraz Namazi Hospital Transplant Center during the years 1999 to 2009. This study is a historical cohort study, which examined the graft survival rate among 103 kidney transplant patients with diabetes. The Kaplan-Meier method was used to determine the survival rate and the log-rank test was used to compare survival curves; P-value of less than 0.05 was considered significant. The mean follow-up period of patients was 48.15 ± 31.05 months (range: 3.07-118.03 months), and the estimated nine-year graft survival rate was 84.2% (±0.045). Based on the results of the Cox regression model, age of the donor was a contributing factor to graft survival rate. In summary, the graft survival rate in our cohort is satisfactory and comparable with reports from other larger centers in the world.

Graft survival rate of renal transplantation: a single center experience, (1999-2009).

BACKGROUND: Renal transplantation is the best option for treatment of the end-stage renal diseases and has more advantages than dialysis. The objective of this study is to determine the ten-year graft survival rate of renal transplantation and its associated factors in patients who have been transplanted from March 1999 to March 2009 in Nemazee Hospital Transplantation Center. METHODS: This is a historical cohort study of 1356 renal transplantation carried out during 1999 to 2009. Kaplan-Meier method was used to determine the survival rate, log rank test to compare survival curves, and Cox regression model to determine hazard ratios and for modeling of variables affecting survival. RESULTS: The 1, 3, 5, 7 and 10 years graft survival rates were 96.6, 93.7, 88.9, 87.1 and 85.5 percent, respectively.Cox regression model revealed that the donor source and creatinine level at discharge were effective factors in graft survival rate in renal transplantation. CONCLUSION: Our study showed that 10 year graft survival rate for renal transplantation in Nemazee Hospital Transplantation Center was 85.5% and graft survival rate was significantly related to recipients and donor's age,donor source and creatinine level at discharge. Our experience in renal transplantation survival rate indicates asuccess rate comparable to those noted in other reports.

Maternal and prenatal risk factors for childhood leukemia in southern of iran.

BACKGROUND: The causes of childhood leukemia as the most common malignancy in children are vastly unknown.The aim of this study is to evaluate the relationship between maternal birth characteristics with environmental exposures in childhood leukemia. METHODS: This is a case-control study which consists of children younger than 18 years old suffering from leukemia who reside at Fars Province of Iran. Patients were individually matched with variables such as age, sex and residence region. In order to evaluate the relationships between each variable and the risk of leukemia, odds ratio(OR) and 95% confidence interval (CI) were estimated using conditional logistic regression. RESULTS: Statistically, the association between risk of childhood leukemia with birth order (OR=6.177, 95%CI:2.551-14.957), pet ownership (OR=2.565, 95%CI: 1.352-4.868) and history of leukemia in first and second degree relatives (OR=2.667, 95%CI: 1.043-6.815) was significant. However, there was no significant association between daycare attendance, history of miscarriage, number of siblings and history of mother's diagnostic radiology tests with risk of childhood leukemia. CONCLUSION: Although no definite etiologic factor for acute childhood leukemia has been clearly defined, the contribution of environmental risk factors in the context of genetic predisposition are strongly elucidated.

Long-term survival of living donor renal transplants: A single center study.

Kidney transplantation is the treatment of choice for end-stage renal disease. The aim of this study was to determine the ten-year graft survival rate of renal transplantation in patients who have been transplanted from live donors. This is a historical cohort study designed to determine the organ survival rate after kidney transplantation from live donor during a 10-year period (from March 1999 to March 2009) on 843 patients receiving kidney transplant in the transplantation center of Namazi hospital in Shiraz, Iran. Kaplan-Meier method was used to determine the survival rate, log-rank test was used to compare survival curves, and Cox proportional hazard model was used to multivariate analysis. Mean follow-up was 53.07 ± 34.61 months. Allograft survival rates at 1, 3, 5, 7, and 10 years were 98.3, 96.4, 92.5, 90.8, and 89.2%, respectively. Using Cox proportional hazard model, the age and gender of the donors along with the creatinine level of the patients at discharge were shown to have a significant influence on survival. The 10-year graft survival rate of renal transplantation from living donor in this center is 89.2%, and graft survival rate in our cohort is satisfactory and comparable with reports from large centers in the world.

Preterm delivery risk factors: a prevention strategy in Shiraz, Islamic Republic of Iran.

From 3 February-5 March, 2000, 1117 pregnant women attending 36 health centres in Shiraz were categorized as high risk (n = 519) and low risk (n = 598) based on the presence of preterm delivery risk factors. High-risk women received training on strategies to reduce the risk of premature delivery. The frequencies of preterm delivery in the low- and the high-risk groups were 3.0% and 14.6% respectively (P < 0.001). The significant factors for preterm delivery were cervical dilation > 1 cm, premature uterine contractions, multifetal gestation and smoking. Premature delivery was significantly lower in the high-risk group compared with a similar group in a previous study who had not received training.

Preterm delivery risk factors: a prevention strategy in Shiraz, Islamic Republic of Iran

From 3 February-5 March, 2000, 1117 pregnant women attending 36 health centres in Shiraz were categorized as high risk [n = 519] and low risk [n = 598] based on the presence of preterm delivery risk factors. High-risk women received training on strategies to reduce the risk of premature delivery. The frequencies of preterm delivery in the low- and the high-risk groups were 3.0% and 14.6% respectively [P < 0.001]. The significant factors for preterm delivery were cervical dilation > 1 cm, premature uterine contractions, multifetal gestation and smoking. Premature delivery was significantly lower in the high-risk group compared with a similar group in a previous study who had not received training

Problems related to shiftwork for health care workers at Shiraz University of Medical Sciences.

A cross-sectional study of shiftwork-related problems was carried out among health care workers at hospitals of Shiraz University of Medical Sciences, Islamic Republic of Iran. Data on personal details, shift schedule and adverse effects of shiftwork were collected from 432 randomly selected subjects by questionnaire. Sleep, social and subjective problems were more prevalent in shiftworkers than day workers. Irregular shiftwork schedules caused more social and subjective problems, as well as work dissatisfaction. Voluntary selection of shiftworking produced fewer health problems.

Problems related to shiftwork for health care workers at Shiraz University of Medical Sciences

A cross-sectional study of shiftwork-related problems was carried out among health care workers at hospitals of Shiraz University of Medical Sciences, Islamic Republic of Iran. Data on personal details, shift schedule and adverse effects of shiftwork were collected from 432 randomly selected subjects by questionnaire. Sleep, social and subjective problems were more prevalent in shiftworkers than day workers. Irregular shiftwork schedules caused more social and subjective problems, as well as work dissatisfaction. Voluntary selection of shiftworking produced fewer health problems

An analysis of risk for secondary hemorrhage in traumatic hyphema.

OBJECTIVE: Factors such as size of hyphema, intraocular pressure, initial visual acuity, and use of steroids or antifibrinolytic drugs may be associated with the likelihood of rebleeding in traumatic hyphema. The association of the visual outcome with secondary hemorrhage has been questioned. DESIGN: Randomized, placebo-controlled, clinical trial. PARTICIPANTS: Two hundred and thirty-eight patients who had hyphema develop after blunt trauma. INTERVENTION: Eighty patients received oral tranexamic acid, 80 patients received placebo, and 78 patients received oral prednisolone. MAIN OUTCOME MEASURES: Secondary hemorrhage and vision at the time of discharge from the hospital were measured. RESULTS: Rebleeding occurred in 43 (18%) of the patients and was prevented significantly by oral tranexamic acid compared with the placebo (odds ratios [OR] = 0.39; 95% confidence interval [CI], 0.17, 0.89). Occurrence of secondary hemorrhage had weak associations with initial high intraocular pressure (OR = 2.7; 95% CI, 0.99, 7.3) and initial visual acuity of 6/60 or less (OR = 1.8; 95% CI, 0.9, 3.7). Secondary hemorrhage had no statistical association with age, gender, oral prednisolone, size of hyphema, and retinal damage. Visual acuity of 6/60 or less at the time of discharge was significantly associated with rebleeding (OR = 10.5; 95% CI, 3.7, 29.2), initial visual acuity of 6/60 or less (OR = 9.9; 95% CI, 2.8, 38.0), retinal damage (OR = 14.6; 95% CI, 3.8, 55.8), and male gender (OR = 6.5; 95% CI, 1.4, 31.9). Final visual acuity had no significant statistical association with age, use of oral prednisolone or tranexamic acid, and size of hyphema. CONCLUSIONS: High intraocular pressure and low vision at the time of first examination may be associated with increased chance of rebleeding. Retinal damage, secondary hemorrhage, male gender, and initial poor vision are associated with a worse visual outcome in patients with traumatic hyphema.