Publications by authors named "SeyedAhmad SeyedAlinaghi"

89 Publications

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

Safety and effectiveness of high-dose vitamin C in patients with COVID-19: a randomized open-label clinical trial.

Eur J Med Res 2021 Feb 11;26(1):20. Epub 2021 Feb 11.

Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Boulevard, Tehran, Iran.

Background: Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease.

Methods: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen.

Results: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups.

Conclusions: We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020.
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http://dx.doi.org/10.1186/s40001-021-00490-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877333PMC
February 2021

COVID-19 and Alcohol Misuse: A Case Report.

Infect Disord Drug Targets 2021 Feb 3. Epub 2021 Feb 3.

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences. 0.

In the beginning of 2020, a newly emerged virus, now named SARS-CoV-2, began to spread in China. After four months, it has reached all over the globe, infecting more than 2.5 million people. Currently, there are no proved treatments available. However, in social media, false information about alcohol consumption and its role against the virus is spreading. We described a victim of these false facts who presented with reduced eyesight due to alcohol drinking, a few days later showed symptoms of COVID-19 and, even though treated, lost his eyesight partially. Alcohol taking has no preventive or curing effect on COVID-19 and negatively impacts the body and immune system, which, therefore, should not be considered a treatment for COVID-19 disease.
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http://dx.doi.org/10.2174/1871526521666210203214533DOI Listing
February 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

Constrictive Pericarditis Associated with Coronavirus Disease 2019 (COVID-19): A Case Report.

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

Department of Infectious Diseases, Imam Khomeini Hospital complex, Tehran University of Medical Sciences, Tehran. Iran.

Since December 2019, there has been an increasing number of patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) around the world. As of March 2020, the World Health Organization declared a global pandemic. To our best knowledge, this is the first report of a patient with SARS-CoV-2 infection presenting with constrictive pericarditis, possibly from the COVID infection. She was presented after a week of fever, persistent dry cough, and diarrhea. She received a single dose of hydroxychloroquine 400 mg, Oseltamivir 75 mg every 12 hours, lopinavir/ritonavir (Kaletra) 400/100 mg every 12 hours, and levofloxacin 750 mg daily. After 24 hours, she was immediately transferred to the Intensive Care Unit (ICU) because of dyspnea and progressive respiratory failure with a drop of the O2 saturation to 70%. After a week of progress, her respiratory condition deteriorated again. She was re-admitted to the ICU and she expired. She died due to isolated constrictive pericarditis, most probably caused by SARS-CoV-2.
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http://dx.doi.org/10.2174/1871526520666201209145001DOI Listing
December 2020

NLRP3 and IL-1β Gene Expression Is Elevated in Monocytes From HIV-Treated Patients With Neurocognitive Disorders.

J Acquir Immune Defic Syndr 2021 Apr;86(4):496-499

Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.

Background: Systemic immune activation and inflammation in chronic HIV infection are driving factors of non-AIDS-related events, including neurocognitive impairment. The role of inflammasome in monocytes from patients with HIV infection has been extensively studied, but its association with the extent of neurocognitive dysfunction has been poorly investigated.

Methods: We enrolled 79 HIV-positive patients; 44 with varying levels of HIV-associated neurocognitive disorder (HAND) and 35 without and 8 healthy donors. HAND subtypes included asymptomatic neurocognitive impairment (asymptomatic neurocognitive impairment; n = 19), mild neurocognitive disorder (MND; n = 17), and HIV-associated dementia (n = 8). We quantified plasmatic concentrations of proinflammatory cytokines (TNF-α, IL-6, IL-17A, IL-1β, and IFN-γ) for all HIV patients, and the mRNA expression of genes involved in the inflammasome activity (NLRP3, PYCARD, NAIP, AIM2, IL-1β, and IL-18) in monocytes of a subgroup of 28 HIV patients and 8 healthy donors.

Results: HIV patients' plasma concentrations of IFN-γ, IL-1β, and IL-17A were undetectable. Levels of TNF-α and IL-6 were similar among the HIV patient groups. A trend toward an increased expression of inflammasome genes according to neurocognitive disorder severity was observed. Of note, the NLRP3 mRNA relative expression was higher in MND compared with other groups, and IL-1β was lower in MND than HIV-associated dementia patients.

Conclusions: Changes in inflammasome components in circulating monocytes according to different HAND severity suggest that NLRP3 may be a possible biomarker or target to better understand and treat the link between systemic inflammation and neurocognitive impairment in HIV infection.
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http://dx.doi.org/10.1097/QAI.0000000000002588DOI Listing
April 2021

Pulmonary Valve Endocarditis: A Case Report.

Infect Disord Drug Targets 2020 Dec 3. Epub 2020 Dec 3.

Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran,. Iran.

Isolated pulmonary valve endocarditis (PVE) is an extremely uncommon clinical finding comprising less than 1.5-2% of cases for infective endocarditis. It is a challenging condition to diagnose mainly because of nonspecific signs and symptoms at presentation. A 58-year-old married and retired man was admitted to a community hospital for evaluation of chest pain. Transesophageal echocardiography (TEE), 2 days after, revealed semi-mobile vegetation on the pulmonary valve and pulmonary artery wall. Moreover, occlude devices at the root of the aorta, and the pulmonary artery was seen. Left ventricular ejection fraction (LVEF) with systolic dysfunction, mild aortic insufficiency (AI), mild tricuspid regurgitation (pulmonary artery pressure of 50 mmHg) without pericardial effusion, was also reported in Echocardiography. Blood cultures, viral markers, and Brucella IgG and IgM titration were negative during the admission. The patient received a 4-week course of intravenous antibiotic therapy included Ceftriaxone and Teicoplanin (Targocid).
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http://dx.doi.org/10.2174/1871526520999201203212135DOI Listing
December 2020

HIV in Iran: onset, responses, and future directions.

AIDS 2021 03;35(4):529-542

Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, USA.

Iran, a country in the Middle East and North Africa (MENA) region, has been actively involved in the fight against HIV/AIDS over the past three decades. The unique features of the HIV epidemic in Iran are reflected by the modes of transmission and its recent changes to improve management and prevention programs. In this review, we recount the initial onset and subsequent spread of HIV infection in Iran, beginning with the first case diagnosed to the ongoing responses and most recent achievements in controlling this epidemic. Although in the MENA region, Iran is one of the pioneers in implementing pertinent policies including harm reduction services to decrease HIV incidence, drug injection still continues to be the major risk of infection. In line with other nations, the programs in Iran aim at the UNAIDS 90-90-90 targets (UNAIDS 90-90-90 global targets to end the AIDS epidemic by 2020: by 2020, 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will have viral suppression) and to eliminate mother-to-child HIV transmission. In this article, we discuss the strengths and shortcomings of the current HIV programs and offer suggestions to provide a better perspective to track and respond to the HIV epidemic. More generally, our account of the national religious and cultural circumstances as well as obstacles to the approaches chosen can provide insights for decision-makers in other countries and institutions with comparable settings and infrastructures.
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http://dx.doi.org/10.1097/QAD.0000000000002757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924262PMC
March 2021

The relationship between social roles and psychosocial adjustment in women with HIV: A structural equation model.

Brain Behav 2021 Jan 20;11(1):e01943. Epub 2020 Nov 20.

Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran.

Background: The human immunodeficiency virus is a unique social phenomenon that affects almost all the aspects of the social and economic life of individuals. The present study was conducted for the path analysis of the relationship between social roles and psychosocial adjustment in women with AIDS.

Methods: This cross-sectional study was conducted in 2019 on 240 women with HIV who referred to the Counseling Center for Behavioral Diseases of Imam Khomeini Hospital in Tehran. The eligible individuals entered the study through convenience sampling, and data were collected using five questionnaires, including the Psychosocial Adjustment to Illness Scale, the Perceived Social Support Scale, the Multidimensional Health Locus of Control Scales, the Illness Perception Questionnaire, the Experiences in Close Relationship Scale, and a socio-demographic checklist. Data were analyzed using SPSS 16 and Lisrel 8.8 software.

Results: According to the results of the path analysis, internal health locus of control and patient's age have a significant positive relationship with psychosocial adjustment only through the direct path, and among them, patient's age has the greatest positive and direct relationship (B = 0.139). In the indirect path, education, external health locus of control, anxiety in experiences of close relationships, and perceived support have the greatest relationship with psychosocial adjustment, and among these variables, education has the highest positive relationship (B = 0.06). Illness perception, avoidance in experiences of close relationships, and chance locus of health control are associated with psychosocial adjustment through both direct and indirect paths, and among these variables, chance locus of health control has the greatest overall relationship with psychosocial adjustment (B = 0.238).

Conclusion: Based on the results, social roles and physical health are directly/indirectly associated with psychosocial adjustment, which emphasizes the need to pay more attention to all three aspects of psychosocial health, especially in this vulnerable group of the society.
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http://dx.doi.org/10.1002/brb3.1943DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7821615PMC
January 2021

Transmission Modes of COVID-19: A Systematic Review.

Infect Disord Drug Targets 2020 Nov 15. Epub 2020 Nov 15.

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

Background: The Coronavirus disease 19 (COVID-19) is a highly transmittable viral infection that initiated in Wuhan, China and has spread around the world. The high prevalence and spread ways of COVID-19 have become an international challenge that requires careful consideration. We aimed to review the current evidence of COVID-19 transmission modes.

Methods: This study was a systematic review that was done to identify current evidence on transmission modes of COVID19. We searched selected keywords in six important databases to discover related sources on the main objective of the study. To identify studies meeting the inclusion criteria, the authors screened the titles and abstracts of retrieved documents. The appropriate articles were selected and their results were discussed to make the final inclusion.

Results: We identified five potential transmission modes of COVID-19 including airborne, droplet, contact with contaminated surfaces, oral and fecal secretions. Furthermore, some studies have pointed out other modes of virus transmission, such as person to person, and direct contact with animals.

Conclusion: Droplet and contact with contaminated surfaces were the most frequent transmission modes of COVID-19. Fecal excretion, environmental contamination, and fluid pollution might contribute to a viral transmission. The possibility of fecal transmission of COVID-19 has implications, especially in areas with poor sanitation and the environmental pollution can be caused by patients with SARS-CoV-2 through respiratory droplets and feces, subsequently, the human environment will change to a potential medium of virus transmission.
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http://dx.doi.org/10.2174/1871526520666201116095934DOI Listing
November 2020

A Patient with COVID-19 Pneumonia Presenting with Plural Effusion: A Case Report.

Infect Disord Drug Targets 2020 Nov 15. Epub 2020 Nov 15.

Black Dog Institute, University of New South Wales. Australia.

In February 2020, coronavirus disease (COVID-19) emerged in Tehran, Iran. Herein, we reported clinical features, laboratory tests, unusual radiological characteristics and therapeutic course of a patient with initial mild clinical symptoms at presentation with progression to pneumonia and pleural effusion in emergency unit of a referral hospital.
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http://dx.doi.org/10.2174/1871526520666201116095440DOI Listing
November 2020

Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial.

Scand J Med Sci Sports 2021 Mar 29;31(3):720-732. Epub 2020 Nov 29.

Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiab'a, Brazil.

To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n = 20; age = 38.3 ± 4.9) or non-exercise control group (n = 20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65-80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6-months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2-L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow-up for the Lumbar spine (L2-L4), femoral neck, and 1/3 radius (all, P < .05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P < .001). We observed a decrease in percent body fat, fat mass, IL-6, TNF-α, and myostatin in the RT+AT group (P < .001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P < .001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.
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http://dx.doi.org/10.1111/sms.13871DOI Listing
March 2021

Safety and effectiveness of azithromycin in patients with COVID-19: An open-label randomised trial.

Int J Antimicrob Agents 2020 Oct 25;56(4):106143. Epub 2020 Aug 25.

Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Keshavarz Boulevard, Tehran University of Medical Sciences, Tehran 14197-33141, Iran. Electronic address:

As no specific pharmacological treatment has been validated for use in coronavirus disease 2019 (COVID-19), we aimed to assess the effectiveness of azithromycin (AZM) in these patients at a referral centre in Iran. An open-label, randomised controlled trial was conducted on patients with laboratory-confirmed COVID-19. A total of 55 patients in the control group receiving hydroxychloroquine (HCQ) and lopinavir/ritonavir (LPV/r) were compared with 56 patients in the case group who in addition to the same regimen also received AZM. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American College of Cardiology (ACC) risk assessment for use of AZM and HCQ. The main outcome measures were vital signs, SpO levels, duration of hospitalisation, need for and length of intensive care unit admission, mortality rate and results of 30-day follow-up after discharge. Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO levels at discharge were significantly higher, the respiratory rate was lower and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. Patients who received AZM in addition to HCQ and LPV/r had a better general condition. HCQ+AZM combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmia based on the ACC criteria.
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http://dx.doi.org/10.1016/j.ijantimicag.2020.106143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445147PMC
October 2020

Superior Mesenteric Venous (SMV) Thrombosis Accompanied with Appendicitis in a Patient with Primary Diagnosis of Typhoid Fever.

Infect Disord Drug Targets 2020 Jul 31. Epub 2020 Jul 31.

Department of Clinical Pharmacy, School of pharmacy, Tehran University of Medical Sciences, Tehran. Iran.

Septic thrombophlebitis of the Superior Mesenteric Venous (SMV) is rarely accompanied by appendicitis, and symptoms are atypical, so the diagnosis is commonly delayed, resulting in it is associated with high mortality. We report a case of neglected SMV septic thrombophlebitis is caused by appendicitis. The patient represented with fever, vague abdominal pain without rebound tenderness, and history of the consumption of contaminated water. Antibiotic initiated due to suspicious typhoid fever. Then typhoid fever was ruled out. Computed tomography (CT) scans revealed micro-abscess forming complicated appendicitis and the thrombus in SMV. The patient underwent a laparoscopic appendectomy, during which retrocecal gangrened perforated appendix with a 2×2 cm abscess was drained. Based on positive culture with ESBL organism meropenem was initiated. Appendectomy and treatment with broad-spectrum antibiotics and anticoagulation led to a full recovery.
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http://dx.doi.org/10.2174/1871526520666200731180042DOI Listing
July 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

Prevalence of COVID-19-like Symptoms among People Living with HIV, and Using Antiretroviral Therapy for Prevention and Treatment.

Curr HIV Res 2020 ;18(5):373-380

Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Background: COVID-19 has spread globally with remarkable speed, and currently, there is limited data available exploring any aspect of the intersection between HIV and SARSCoV- 2 co-infection.

Objective: To estimate the prevalence of clinical symptoms associated with COVID-19 among people living with HIV (PLWH) in Tehran, Iran.

Design: Cross-sectional study.

Methods: A total of 200 PLWH were recruited through the positive club via sampling, and completed the symptom-based questionnaire for COVID-19, which was delivered by trained peers.

Results: Of 200 participants, respiratory symptoms, including cough, sputum, and shortness of breath, were the most prevalent among participants, but only one person developed symptoms collectively suggested COVID-19 and sought treatments.

Conclusion: It appears that existing infection with HIV or receiving antiretroviral treatment (ART) might reduce the susceptibility to the infection with SARS-CoV-2 or decrease the severity of the infection acquired. Further research is needed to understand causal mechanisms.
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http://dx.doi.org/10.2174/1570162X18666200712175535DOI Listing
October 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

Olfactory and gustatory dysfunctions due to the coronavirus disease (COVID-19): a review of current evidence.

Eur Arch Otorhinolaryngol 2021 Feb 17;278(2):307-312. Epub 2020 Jun 17.

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

Introduction: It is reported that coronavirus disease (COVID-19) can affect the sense of smell and taste of infected people. The pathobiology of this virus is still incompletely known, and it is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions. We aimed to review current evidence on olfactory and gustatory dysfunctions caused by COVID-19.

Methods: This study was a narrative review performed in 2020 to investigate the olfactory and gustatory dysfunctions of the COVID-19. We searched eight keywords in six databases to determine the related documents on the main objective of the study. To discover studies meeting the inclusion criteria, the authors screened the titles and abstracts of the identified articles. The appropriate studies were included and their results were discussed to make the final selection.

Results: We have studied 24 current articles on the olfactory and gustatory dysfunctions due to COVID-19. A review of current studies has shown that we have a surge in the spread of olfactory and gustatory dysfunctions that happened during the epidemic of COVID-19 infection. Most studies (95.8%) have confirmed the symptoms of anosmia in patients with SARS-CoV-2 infection. A review of current studies showed that, in addition to anosmia, evidence of ageusia and dysgeusia (parageusia) was also seen in patients with COVID-19.

Conclusion: The results of our study support recent reports that SARS-CoV-2 may infect oral and nasal tissues and cause olfactory and gustatory dysfunctions. These findings may aid future research on the diagnosis, prevention, and treatment of COVID-19 consequences.
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http://dx.doi.org/10.1007/s00405-020-06120-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297932PMC
February 2021

Symmetrical polyneuropathy in coronavirus disease 2019 (COVID-19).

IDCases 2020 15;21:e00815. Epub 2020 May 15.

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

The outbreak of the novel coronavirus that began in late December 2019 was announced as a pandemic by the World Health Organization as the number of cases is increasing exponentially throughout the globe. We presented a patient with confirmed SARS-CoV-2 pneumonia developing symmetric polyneuropathy. To our knowledge, extrapulmonary clinical presentations of 2019 novel coronavirus disease (COVID-19) have rarely been reported. This case highlights the possible association between SARS-CoV-2 infection and nervous system involvement.
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http://dx.doi.org/10.1016/j.idcr.2020.e00815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255269PMC
May 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

Isolated severe thrombocytopenia in a patient with COVID-19: A case report.

IDCases 2020 29;21:e00820. Epub 2020 May 29.

Mazandaran University of Medical Sciences, School of Medicine, Sari, Iran.

COVID-19 is known to cause serious respiratory symptoms and involvement of other body systems such as hematopoietic, neurological and the immune system. In this report, we described a case of a COVID-19 patient who presented with no pulmonary involvement but severe thrombocytopenia. She suffered from headache and malaise with no respiratory symptoms, fever or chills. Chest radiological imaging was unremarkable but, the laboratory results showed significant thrombocytopenia associated with relatively decreased lymphocytes. Based on her high-risk work environment, a reverse transcription polymerase chain reaction (RT-PCR) test was performed and SARS-CoV-2 RNA was detected in the nasopharyngeal swab. Complete blood count (CBC) of patient was re-checked during admission and platelet count showed rising trend up to normal levels. A narrow diagnostic approach where only febrile patients with pulmonary symptoms are evaluated for a COVID-19 diagnosis will result in many missed diagnoses; so it is important that physicians are familiar with atypical and rare presentations of COVID-19, such as isolated thrombocytopenia.
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http://dx.doi.org/10.1016/j.idcr.2020.e00820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255984PMC
May 2020

Isolated Anosmia as a Presentation of COVID-19: An Experience in a Referral Hospital.

Infect Disord Drug Targets 2020;20(3):350

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

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http://dx.doi.org/10.2174/1871526520999200520173216DOI Listing
August 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

Lung Involvement Found on Chest CT Scan in a Pre-Symptomatic Person with SARS-CoV-2 Infection: A Case Report.

Trop Med Infect Dis 2020 Apr 7;5(2). Epub 2020 Apr 7.

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran 1419733141, Iran.

The novel coronavirus SARS-CoV-2 infection is spreading worldwide, and there are many reports of acute respiratory distress syndrome caused by this infection. However, asymptomatic lung involvement has not been reported. We hereby present the case of a 44-year-old health-care worker, who was found to be infected with the SARS-CoV-2 virus after a CT-scan performed for an unrelated condition revealed a lesion in the lung field compatible with COVID-19 infection. His condition deteriorated initially, but eventually improved with supportive treatment and the compassionate use of antivirals and antimalarials and is now in a stable condition.
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http://dx.doi.org/10.3390/tropicalmed5020056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344491PMC
April 2020

HIV and risk behaviors among visitors of inmates at the Great Tehran Prison, Iran, 2018.

Open AIDS J 2020 23;14(1):35-40. Epub 2020 May 23.

University of California, University of San Francisco, San Francisco, United States.

Objectives: The objective of the present study was to determine the prevalence of HIV and risk behaviors among the inmates' visitors at the Great Tehran Prison in 2018.This population is more likely to be infected with HIV due to their relationship with inmates. However, they have not been prioritized to the other populations in comparison to inmates who are usually prioritized over others.

Method: Using a convenient sampling method, we recruited inmates' visitorsat the Great Tehran Prison in 2018. An anonymous questionnaire collected information on the participant's demographic characteristics, relationship withinmate, imprisonment history, drug-related risk behaviors, and HIV-related risk behaviors.Rapid HIV blood test detected HIV positive people. To examine the association between risk behaviors and HIV infection, we used a multivariate logistic regression model to calculate the adjusted Odds Ratio (OR)(adjusted Odds ratio of 23.140, 95% CI OD: 1.994-268.5).

Results: 1131 visitors were asked to participate in the study; out of which 1120 consented (99%).Out of the 1120 participants, 55.2% were female, and the majority (72.4%) aged older than 35 years. Of those who had a sexual partner, 50% did not usea condom in the last 6 months. Overall, HIV prevalence was 0.4% in the inmate visitors, but it was significantly higher among those with a history of drug injection().

Conclusion: Our findings indicated that overall the HIV prevalence is low amonginmates' visitors; Subgroups with a history of injection have high HIV prevalence which needs to beprioritized for HIV screening and treatment.
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http://dx.doi.org/10.2174/1874613602014010035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920085PMC
May 2020

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

Comparison of HIV Indicators after the Implementation of a New Model for TB and HIV Management in an Iranian Prison.

Infect Disord Drug Targets 2020 ;20(6):778-783

Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran.

Objectives: A new national clinical guideline for the management of tuberculosis and HIV in Iranian prisons was released in 2011. The aim of this study was to compare HIV indicators in the case and control prisons after implementation of the new guideline.

Methods: This report examines outcomes observed during the pilot phase of its implementation at a case prison from October 2013 to June 2014 compared to a control prison that had not yet implemented the guideline. The case prison included incarcerated individuals in the Great Tehran Prison. A prison in Alborz province was considered as a control group. Pearson's Chi-squared, two-sample t-test, paired t-test and Kruskal-Wallis were used for the analysis.

Results: The intervention significantly increased the total number of inmates tested for HIV and of diagnoses of HIV-positive inmates in the case prison compared to the control prison (P<0.001). Moreover, coverage of antiretroviral therapy was higher in the case prison compared to the control prison (P=0.015).

Conclusion: We recommend the implementation of this guideline in all Iranian prisons.
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http://dx.doi.org/10.2174/1871526519666191015151639DOI Listing
January 2020