Publications by authors named "Omid Dadras"

17 Publications

  • Page 1 of 1

Late Complications of COVID-19; a Systematic Review of Current Evidence.

Arch Acad Emerg Med 2021 20;9(1):e14. Epub 2021 Jan 20.

Department of Global Health and Socioepidemiology, Graduate School of Medicine, Kyoto University, Kyoto. Japan.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927752PMC
January 2021

The prevalence and associated factors of adverse pregnancy outcomes among Afghan women in Iran; Findings from community-based survey.

PLoS One 2021 15;16(1):e0245007. Epub 2021 Jan 15.

Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran.

Backgrounds: An estimated 2.5 million Afghans are living in the Iran and almost half of them are young women at the childbearing ages. Although the evidence indicates lower rates of antenatal care and higher incidence of pregnancy complications in Afghan compared to Iranian women, the underlying reasons are not well defined. Therefore, in the present study, we aimed to explore the prevalence and associated sociodemographic factors of adverse pregnancy outcomes and examine the impact of intimate partner violence, food insecurity, poor mental health, and housing issues on pregnancy outcome in Afghan women living in Iran.

Methods: In July 2019, we enrolled 424 Afghan women aged 18-44 years old using the time-location sampling at three community health centers in the south region of Tehran province. The data was collected through face to face interviews using the researcher-developed questionnaire. Using bivariate and multivariate analysis, the impact of poor antenatal care, intimate partner violence, food insecurity, and poor mental health was assessed on the incidence of adverse pregnancy outcome.

Results: More than half (56.6%) of Afghan women reported at least one pregnancy complication in their recent pregnancy. The results showed that undocumented, illiterate, and unemployed Afghan women with lower socioeconomic status are more likely to experience adverse pregnancy outcomes. Furthermore, we observed lower prevalence of adverse pregnancy outcomes among documented immigrants with health insurance compared to those with no health insurance. It is also been found that the food insecurity [Adjusted OR = 3.35, 95% CI (1.34-8.36)], poor antenatal care [Adjusted OR = 10.50, 95% CI (5.40-20.39)], intimate partner violence [Adjusted OR = 2.72, 95% CI (1.10-6.77)], and poor mental health [Adjusted OR = 4.77, 95% CI (2.54-8.94)] could adversely impact the pregnancy outcome and we observed higher incidence of adverse outcomes among those suffering from these situations.

Conclusion: To our knowledge, this is the first study that explored the prevalence and associated factors of adverse pregnancy outcomes and the impact of intimate partner violence, food insecurity, poor mental health on pregnancy outcome among Afghan women in Iran. Enhancing the psychosocial support and empowering Afghan women through expanding the social network and safety net should be a priority for the central government and international parties. Psychological counseling should be incorporated into routine maternity care for Afghan refugees. Access to free antenatal care is a right for all Afghan women and it should be facilitated by universal health insurance for all Afghans regardless of their legal status.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245007PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810300PMC
January 2021

Reinfection risk of novel coronavirus (COVID-19): A systematic ‎review of current evidence.

World J Virol 2020 Dec;9(5):79-90

Université Aix-Marseille, Institutde Neuro-physiopathologie (INP), UMR 7051, Faculté de ‎Pharmacie, 27 Bd Jean Moulin, Marseille 546789235, France.

Background: There is recently a concern regarding the reinfection and reactivation of previously reCoVered coronavirus disease 2019 (CoVID-19) patients.

Aim: To summarize the recent findings and reports of CoVID-19 reinfection in patients previously reCoVered from the disease.

Methods: This study was a systematic review of current evidence conducted in August 2020. The authors studied the probable reinfection risk of novel coronavirus (CoVID-19). We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of this study and results.

Results: We reviewed 31 studies. Eight studies described reCoVered patients with reinfection. Only one study reported reinfected patients who died. In 26 studies, there was no information about the status of the patients. Several studies indicated that reinfection is not probable and that post-infection immunity is at least temporary and short.

Conclusion: Based on our review, we concluded that a positive polymerase chain reaction retest could be due to several reasons and should not always be considered as reinfection or reactivation of the disease. Most relevant studies in positive retest patients have shown relative and probably temporary immunity after the reCoVery of the disease.
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http://dx.doi.org/10.5501/wjv.v9.i5.79DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747024PMC
December 2020

A systematic review of ECG findings in patients with COVID-19.

Indian Heart J 2020 Nov-Dec;72(6):500-507. Epub 2020 Nov 13.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction: Since the epidemic of COVID-19 attracted the attention, reports were surrounding electrocardiographic changes in the infected individuals. We aimed at pinpointing different observed ECG findings and discussing their clinical significance.

Methods: We conducted a systematic search in PubMed, Embase, and Scopus databases. We included eligible original papers, reports, letters to the editors, and case reports published from December 2019 to May 10, 2020.

Results: The team identified 20 articles related to this topic. We divided them into articles discussing drug-induced and non-drug-induced changes. Studies reported an increased risk of QTc interval prolongations influenced by different therapies based on chloroquine, hydroxychloroquine, and azithromycin. Although these medications increased risks of severe QTc prolongations, they induced no arrhythmia-related deaths. In the non-drug-induced group, ST-T abnormalities, notably ST elevation, accounted for the most observed ECG finding in the patients with COVID-19, but their relation with myocardial injuries was under dispute.

Conclusion: This systematic review suggests that identifying ECG patterns that might be related to COVID-19 is vital. Provided that physicians do not recognize these patterns, they might erroneously risk the lives of their patients. Furthermore, important drug-induced ECG changes provide awareness to the health-care workers on the risks of possible therapies.
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http://dx.doi.org/10.1016/j.ihj.2020.11.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661958PMC
January 2021

Predictors of mortality in patients with COVID-19-a systematic review.

Eur J Integr Med 2020 Dec 17;40:101226. Epub 2020 Oct 17.

School of Public Health, Central Michigan University, Mount Pleasant, MI, 48859, United States.

Introduction: In the current COVID-19 pandemic, disease diagnosis is essential for optimal management and timely isolation of infected cases in order to prevent further spread. The aim of this study was to systematically review the assessment of risk and model the predictors of mortality in COVID-19 patients.

Methods: A systematic search was conducted of PubMed, Scopus, Embase, Google Scholar, and Web of Science databases. Variables associated with hospital mortality using bivariate analysis were included as potential independent predictors associated with mortality at the  < 0.05 levels.

Results: We included 114 studies accounting for 310,494 patients from various parts of the world. For the purpose of this analysis, we set a cutoff point of 10% for the mortality percentages. High mortality rates were defined as higher than 10% of confirmed positive cases and were given a score of two, while low mortality (<10%) was assigned the score of one. We then analyzed the associations between 72 variables and the observed mortality rates. These variables included a large range of related variables such as demographics, signs and symptoms and related morbidities, vital signs, laboratory findings, imaging studies, underlying diseases, and the status of countries' income, based on the United Nation's classifications.

Conclusion: Findings suggest that older age, hypertension, and diabetes mellitus conferred a significant increased risk of mortality among patients with COVID-19. In the multivariate analysis, only diabetes mellitus demonstrated an independent relationship with increased mortality. Further studies are needed to ascertain the relationship between possible risk factors with COVID-19 mortality.
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http://dx.doi.org/10.1016/j.eujim.2020.101226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568488PMC
December 2020

Barriers and associated factors for adequate antenatal care among Afghan women in Iran; findings from a community-based survey.

BMC Pregnancy Childbirth 2020 Jul 28;20(1):427. Epub 2020 Jul 28.

Department of Health Informatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Background: Almost a third of Afghan women living in Iran are at childbearing age. Antenatal care (ANC) is an inextricable part of healthy pregnancy and could prevent the adverse birth outcomes. Almost 97% of Iranian expectant women are receiving adequate ANC (4 or more visits). However, the situation for pregnant Afghan women is unclear. Some studies indicated low access to ANC among Afghan women. In the present study, we aimed to explore the sociodemographic factors and potential barriers associated with adequate ANC among Afghan women in Iran.

Methods: A cross sectional study was conducted between June 2019 and August 2019. Using time location sampling (TLS), we recruited 424 Afghan women aged 18-45 years old at three health centers in south region of Tehran. The data were collected on sociodemographic characteristics and the reported reasons for inadequate ANC using a questionnaire and analyzed applying bivariate, and multivariate analyses. Factor analysis was performed to reduce the number of potential reasons for inadequate ANC in order to improve the precision of regression analysis.

Results: Almost a third of Afghan women in this study had adequate ANC (≥ 8 visits). The women in older age group, those with higher education and family income, women with longer length of stay, those of legal status were more likely to have adequate ANC. In multivariate analysis, the poor knowledge and attitude toward ANC (AOR = 0.06; 95% CI [0.03-0.15]), the poor quality of services (AOR = 0.17 95% CI [0.07-0.41]); and to some extent, the difficulties in access (AOR = 0.33; 95% CI [0.11-1.00]) were the main obstacles toward adequate ANC among the study population.

Conclusion: Our study emphasized the important role of the personal knowledge and attitude toward ANC with adequate antenatal care among Afghan women in Iran. This could be addressed by well-oriented interventions and health education for Afghan women. The collaboration between central government with international agencies should be directed toward enhancing the social support, promoting the awareness and knowledge, and expanding the safety net services to improve the access and quality care among Afghan women in Iran.
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http://dx.doi.org/10.1186/s12884-020-03121-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389441PMC
July 2020

Bone Marrow Aspiration/Biopsy in the Evaluation of Fever of Unknown Origin in Patients with AIDS.

Infect Disord Drug Targets 2020 Jul 5. Epub 2020 Jul 5.

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran. Iran.

Background: HIV can interrupt the normal development of bone marrow cell lines. Bone marrow aspiration/biopsy (BMA/B) has been described as a diagnostic tool in AIDS patients with fever of unknown origin (FUO). In this study, we aimed to study patients with AIDS who had undergone a BMA/B to investigate FUO and describe the pathologies diagnosed in the biopsy.

Methods: Thirty-four BMA/B samples were collected from AIDS patients admitted for workup of FUO to the infectious disease ward of a tertiary referral HIV center in Tehran, Iran, between September 2014 and September 2015. Data including age, sex, duration of disease, CD4 cell counts, hepatitis B (HBV) and C (HCV) coinfection, the primary presentation of AIDS, and the treatment history were retrieved and analyzed. Patients underwent BMA/B. An expert pathologist reviewed the BMA/B specimens.

Results: The mean age of the patients was 37.5 years (range, 26-56), and 27 (79%) were men. Twenty-seven (79%) patients contracted HIV from injection drug use, and 7 (21%) via sexual transmission. Only 3 (9%) of the BMA/B examinations were normal. Hypocellular bone marrow was diagnosed in 22 (65%) patients. Other pathologies included granulomas in 6 (18%), hematologic malignancies in 2 (6%), and leishmaniasis Aspergillosis, each in 1 (3%) patient. Six (17%) of the specimens were found to have tuberculosis infections.

Conclusion: Hypocellular bone marrow was the most common pathology on BMA/B examinations, followed by the presence of granulomas. Tuberculosis, Aspergillosis, and Leishmaniasis were the opportunistic infections diagnosed on BMA/B specimens. Our results support BMA/B as an appropriate diagnostic tool for early diagnosis of opportunistic infections and malignancies in AIDS. BMA/B is indispensable in the armament of diagnostic tools of the physicians managing AIDS patients.
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http://dx.doi.org/10.2174/1871526520666200705212903DOI Listing
July 2020

Pleural Effusion as a Sign of Coronavirus Disease 2019 (COVID-19) Pneumonia: A Case Report.

Infect Disord Drug Targets 2020 Jun 9. Epub 2020 Jun 9.

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran. Iran.

Background: Recently, COVID-19 infection has become a public health concern. On March 12th, 2020, the World Health Organization (WHO) announced it as a global pandemic. Early diagnosis of atypical cases of COVID-19 infection is critical in reducing the transmission and controlling the present pandemic. In the present report, we described a patient with the chief complaints of dyspnea and dry cough referred to the oncology center at Imam Khomeini Hospital, Tehran with the differential diagnosis of lung cancer who was diagnosed and treated for COVID-19 infection in follow up.

Case Presentation: A 59-year-old patient complained of fever, dry cough, and dyspnea from two weeks ago. The patient had been referred to this center with the differential diagnosis of lung cancer due to the massive pleural effusion in initial chest CT scan. Dyspnea was the patient's main complaint at the time of admission in this center and the oxygen saturation was 84%. In the new chest CT scan, similar findings were observed. Due to the severe respiratory distress, a chest tube was placed in the chest cavity to remove the pleural effusion fluid on day one. The patient's felt relieved immediately after the procedure; however, the oxygen saturation did not raise above 85% despite the oxygen therapy. The cytology of pleural fluid was negative for malignant cells. On day 2, the lymphopenia and high level of CRP suggested the COVID-19 infection. Therefore, a control chest CT scan was conducted and the test for COVID-19 was performed. The CT report indicated the clear pattern of COVID-19's lung involvement in the absence of pleural effusion. Thus, the treatment for COVID-19 was immediately initiated. On day 4, the test reported positive for COVID-19.

Conclusion: Currently, it is important to bear in mind the COVID-19 infection in evaluating the patients with respiratory symptoms. This report indicated how misleading the presentation of chest CT scan could be in clinical judgment. Therefore, we recommend ruling out the COVID-19 infection in all the patients with any pattern of lung involvement to avoid missing the potential cases of this vicious infection.
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http://dx.doi.org/10.2174/1871526520666200609125045DOI Listing
June 2020

Epidemiology of HIV in Iran.

Curr HIV Res 2020 ;18(4):228-236

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.
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http://dx.doi.org/10.2174/1570162X18666200605152317DOI Listing
January 2020

"It is good, but I can't afford it …" potential barriers to adequate prenatal care among Afghan women in Iran: a qualitative study in South Tehran.

BMC Pregnancy Childbirth 2020 May 6;20(1):274. Epub 2020 May 6.

Department of Health Informatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Background: An estimated 96% of registered refugees in Iran are Afghan. Almost half of them are young women at the reproductive age. The adequate maternity care is crucial for healthy pregnancy. There is limited knowledge regarding the access and adequacy of maternity care among Afghan women in Iran. The reports from ministry of health (MOH) implicate higher prevalence of perinatal complications in Afghan population. This mainly attributed to the inadequate prenatal care during pregnancy. Therefore, this paper explores the potential barriers to prenatal care among Afghan women in Iran.

Methods: Using convenience sampling, thirty pregnant Afghan women were recruited at three community health centers with the highest number of Afghan visitors in Tehran, the capital city of Iran. Data were collected through face-to-face interviews in Persian language using an interview guide. The interviewers were two bilingual Afghan graduate midwifery students. Each interview lasted for an hour. The questions regarding the concerns and experienced obstacles in seeking prenatal care were asked. The interviews were transcribed into original language (Persian) and analyzed using content analysis and further translated back into English. The main themes were extracted grouping the similar codes and categories after careful consideration and consensus between the researchers.

Results: The financial constraints and lack of affordable health insurance with adequate coverage of prenatal care services, particularly the diagnostic and screening tests, were the most frequent reported obstacles by Afghan women. In addition, personnel behavior, transportation issues, stigma and discrimination, cultural concerns, legal and immigration issues were also mentioned as the source of disappointment and inadequate utilization of such services.

Conclusions: The findings of present study emphasize the necessity of available and most importantly, affordable prenatal care for Afghan women in Iran. Providing an affordable health insurance with adequate coverage of prenatal and delivery services, could reduce the financial burden, facilitate the access, and ensure the maternal and child health in this vulnerable population. The issues of fear and concern of deportation must be removed for at least illegal Afghan mothers to ensure their access to maternity care and improve the health of both mother and offspring.
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http://dx.doi.org/10.1186/s12884-020-02969-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201652PMC
May 2020

Drug resistance patterns in HIV patients with virologic failure in Iran.

Arch Clin Infect Dis 2019 Dec 28;14(6). Epub 2019 Dec 28.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran.

We reviewed the medical charts of 1,700 patients diagnosed with HIV who referred to a central HIV clinic in Tehran between 2004 and 2017. Participants who had a viral load of > 200 copies/mL after six months or more on antiretroviral therapy (ART) were grouped as virologic failure (VF). We assessed the demographic characteristics, diagnosis date, first ART regimen, and resistance to various ART drugs. Out of 1,700 patients, 72 (4.2%) had a treatment failure. Among those with treatment failure, 51.3% were on zidovudine + lamivudine + efavirenz, 13.9% were on tenofovir + lamivudine + lopinavir/ritonavir, and 12.5% were on tenofovir + emtricitabine + efavirenz. In patients with treatment failure, the highest resistance was to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) combination (44.4%). In these patients, resistance to tenofovir (one of the NRTIs) was 29.1%. The highest treatment failure was observed among patients treated with nevirapine (NVP) and efavirenz (EFV)-based regimen. Our findings suggest that protease inhibitors should be considered as first-line drugs in ART regimens in VF patients in Iran.
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http://dx.doi.org/10.5812/archcid.96531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138207PMC
December 2019

Granulomatosis with Polyangiitis (GPA) in a 15-year-old Girl with Facial Acne-like Ulcers: A Case Report.

Infect Disord Drug Targets 2020 ;20(6):932-936

School of Nursing, George Mason University, 4400 University VA 22030, United States.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a multisystem autoimmune disease of unknown etiology often misdiagnosed as pneumonia. The hallmark features include necrotizing granulomatous inflammation and pauci-immune vasculitis in small and medium-sized blood vessels. We described a 15-year-old female with a history of six months of acne-like facial and peri-auricular lesions. She had received conventional treatment for acne (antibiotics + topical corticosteroid) with no response. She also had a history of chronic coughs, which always diagnosed and treated as sinusitis. In addition, she had a history of frequent dysuria, which always diagnosed and treated as a urinary tract infection. Given the history, with suspicion of a multi-systemic disease such as vasculitis; we performed some diagnostic laboratory and radiologic tests in order to rule out the possible etiologies. The results were positive for cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA). The urine analysis suggested the involvement of kidney micro-vasculature. In addition, two nodular lesions with the cystic pattern were observed in the CT scan of the lungs. However, the skin and nasal biopsies revealed no evidence of chronic necrotizing vasculitis or granulomatous lesion. Nonetheless, treatment was initiated with a strong suspicion of GPA. Following the treatment, the patient's symptoms completely disappeared, and the diagnosis of GPA was confirmed.
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http://dx.doi.org/10.2174/1871526519666191115105036DOI Listing
January 2020

Barriers to Antiretroviral Therapy Adherence in One of the Prisons in Iran.

Infect Disord Drug Targets 2020 ;20(6):848-853

Social Determinants of Health Research Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.

Background: Antiretroviral medications have improved the survival and life quality of people living with HIV and turned HIV into a chronic controllable disease. However, the success of HIV treatment depends on many factors; patient adherence is one the most important indicators. In this study, we explored the potential barriers to an effective adherence antiretroviral therapy (ART) among the HIV-positive prisoners of Ghezel-Hesar prison, Iran.

Methods: To explore and identify the barriers toward ART adherence, a focus group discussion was held with six prisoners eligible for ART but rejected to be treated or did not retain on ART. The prisoners were recruited through purposive sampling method. All the words, behaviors and even body languages were precisely recorded and analyzed to reach the final results.

Results: The most reported obstacles toward ART adherence were the lack of trust in the effectiveness of medications and drug complications. Other reasons were inadequate nutrition, lack of amenities, social stigma, lack of economic and psychological support, misbehavior of prison staff and inadequate methadone prescription for those with opium addiction.

Conclusion: Due to the results and the fact that adequate Methadone prescription for opium addiction, improving life quality and receiving emotional and medical support from staff could improve adherence to HIV medication in prisoners,comprehensive education of prisoners about their health condition along with staff education may improve the life condition of HIV infected prisoners and may cause dramatic improvement in ART adherence and prisoners health.
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http://dx.doi.org/10.2174/1871526519666191113110030DOI Listing
January 2020

The Relationship Between HIV Antibody Titer, HIV Viral Load, HIV p24 Antigen, and CD4 T-cell Count Among Iranian HIV-positive Patients.

Infect Disord Drug Targets 2020 ;20(5):752-757

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

Objective: This study aimed to simultaneously measure and assess the correlation between the available HIV infection parameters including HIV antibody, p24 Antigen, CD4 cell count, and viral load at the different stages of HIV disease among HIV-positive individuals in Iran.

Materials And Methods: Fifty HIV-positive individuals were classified into three stages (1, 2, and 3) according to the HIV disease stages classification, available in Control of Disease and Prevention (CDC) guideline. 10 ml of the venous blood sample was collected to run the tests for HIV antibody and p24 Ag levels, CD4 cell counts, and viral load. Pearson's correlation test was employed to calculate the coefficients for the in-between correlation of different HIV parameters in each stage.

Results: Of 50 participants, 17 (34%), 25 (50%), and 8 (16%) patients belonged to stages 1, 2, and 3, respectively. Sexual relationship was the main route of HIV transmission among the patients (36%); however, injecting drug use (20%) was also reported frequently. There was no significant correlation between the parameters of HIV disease in different stages in the present study.

Conclusion: The findings showed no correlation between HIV parameters in the present study. Considering the fact that the association of HIV antibodies with HIV disease progression in infected individuals is independent of HIV-1 RNA levels, combined measurement of HIV-1 RNA and CD4 cell counts should be routinely carried out in HIV infected patients follow up.
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http://dx.doi.org/10.2174/1871526519666191104144721DOI Listing
January 2020

Determinants of Needle Stick Injuries Among Healthcare Providers at a Tehran University Hospital in 2016: A Descriptive Report.

Infect Disord Drug Targets 2020 ;20(5):743-747

George Mason University, School of Nursing, 4400 University Dr, Fairfax, VA 22030, United States.

Background: Needle Stick Injuries (NSIs) are the most common occupational injuries among HCWs. The aim of this study was to explore the prevalence and distribution of determinants for such injuries in a university hospital in Tehran, Iran, in 2016.

Methods: We conducted a descriptive cross-sectional study in Ziaeian Hospital, a teaching hospital of Tehran University. The medical records of 55 Health Care Workers (HCWs) who experienced NSIs in 2016, were extracted from the hospital registry and analyzed using SPSS version 22.

Results: Available data of 55 HCWs with a history of NSIs were extracted from the hospital registry. The highest number of NSIs belonged to registered nurses (34.6%), licensed practical nurses (14.5%) and medical doctors (12.7%), respectively. The majority of the NSIs occurred in the morning shift (50.9%) followed by night shift (36.4%) and evening shift (12.7%). Most of the NSIs occurred in the emergency department (38.1%) and operating room (18.2%). The healthcare workers reported fatigue as the most common reason for being injured by needles (67.4%). All the HCWs were trained and familiarized with the safety and risk control measures after needle stick exposures in the hospital.

Discussion: The present study described the determinants of NSIs among HCWs in a university hospital. The fatigue and working overload were the main reasons for NSIs. The results of this study could be used to address the shortcoming in the guidelines and protocols to ensure the sustainable safety measures that could reduce the occurrence of the NSIs in hospitals in Iran.
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http://dx.doi.org/10.2174/1871526519666191009153027DOI Listing
January 2020

Hepatitis A Seroprevalence Among Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study in Iran During 2016-2017.

Infect Disord Drug Targets 2020 ;20(5):748-751

Department of Infectious Diseases and Tropical Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting.

Methods: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19.

Results: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001).

Conclusion: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.
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http://dx.doi.org/10.2174/1871526519666191009144848DOI Listing
January 2020

Levofloxacin Versus Ceftriaxone and Azithromycin Combination in the Treatment of Community Acquired Pneumonia in Hospitalized Patients.

Recent Pat Antiinfect Drug Discov 2018 ;13(3):228-239

Graduation Program of Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiaba, Brazil.

Background: In Asia, an estimated one million deaths are caused by communityacquired pneumonia (CAP) each year. Despite the high mortality in elderly people, a large number of CAP patients have been treated and survived with optimal life expectancy. A few studies have been done on adult CAP therapeutic approaches in Asia. Moreover, differences have been noted between these studies and European data. We aimed to investigate the efficacy of oral Levofloxacin (TAVANEX), 750 mg, once daily for five days versus parenteral Ceftriaxone 1gr BD, plus oral Azithromycin (250 mg, once daily) for seven to ten days (standard regimen) in CAP treatment.

Materials And Methods: We conducted a prospective randomized trial among 150 patients with CAP in Qaem Hospital of Alborz city from December 2016 to June 2017. A group of CAP patients were randomized in two treatment groups. One group was treated with oral Levofloxacin (TAVANEX), 750 mg, once daily for five days and the other group with parenteral Ceftriaxone 1gr BD plus oral Azithromycin (250 mg, once daily) for seven to ten days (standard regimen). The efficacy and side effects of the assigned drugs were compared between two groups. The probability level for statistical significance was set at P ≤ 0.05.

Results: The body temperature (P value=0.09), WBC count (P value=0.15), respiratory sounds (P value=0.18) and admission duration (P value=0.15) showed no significant differences after treatment between two groups. There was no report of hospital mortality, clinical deterioration and antibiotic escalation during hospital admission in both groups of study. In standard regimen group, only two (2.7%) patients had skin rash while in Levofloxacin group one case (1.3%) had skin rash, two patients (2.7%) had gastrointestinal problems and three (4%) patients showed central nervous system (CNS) complications. In both groups, the reticulonodular pattern was more frequently observed in Chest X-ray. Although standard regimen group (n=27, 36%) showed more consolidation than patients in Levofloxacin group (n=22, 29.3%), and the ground glass pattern was observed more in Levofloxacin group.

Conclusion: We concluded that monotherapy with oral Levofloxacin was as effective as treatment with Ceftriaxone plus Azithromycin combination in patients with CAP who required hospitalization.
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http://dx.doi.org/10.2174/1574891X13666181024154526DOI Listing
April 2019