Determinant factors of survival time in a cohort study on HIV patient using by time-varying cox model: Fars province, south of Iran

Background and aims: The pandemic of AIDS is a global emergency and one of the biggest challenges in social and individual life. This study aimed to evaluate the survival time of HIV patients and its effective factors. Methods: This historical cohort study was conducted on the individuals infected with HIV in Fars province, south of Iran, during 2006 to 2013. The study data were obtained from information documented in the patients’ records. For statistical analysis, at first, Kaplan-Meier survival analysis was used as univariate method and then, time varying Cox regression model was applied as multiple analyses. Results: The findings of the present study implied that some variables could play the role of risk factors in HIV patients, and shorten the patients’ life span e.g. older age, female gender, unemployment, delay in HIV diagnosis, drug injection, and higher Hemoglobin (HGB) levels. Conclusion: Many factors affect HIV patients’ survival time. Some of these factors, such as gender and genetic factors, are irreversible. However, some others, including drug injection, are preventable. This implies that in order to slow down the speed of HIV conversion to AIDS and delay the occurrence of death, special attention must be paid to these factors and changing the patients’ conditions accordingly

Hepatitis C virus infection in HIV positive attendees of Shiraz behavioral diseases consultation center in southern Iran

Objective: To determine the prevalence of HCV co-infection and its correlation with demographic and risk factors among human immunodeficiency virus (HIV)-infected individuals attending Shiraz behavioral diseases consultation (SBDC) Center in southern Iran. Materials and Methods : In a cross-sectional study, 226 consecutive HIV-positive patients who referred to SBDC Center from April 2006 to March 2007 were interviewed face-to-face to record demographic data and risk factors of HIV transmission. A 10ml sample of venous blood was drawn from every subject and tested for HCV-antibodies by third generation enzyme linked immunosorbant (ELISA) and recombinant immunoblot assays (RIBA). All samples were also analyzed by qualitative reverse transcriptase polymerase chain reaction (RT-PCR) for detection of HCV-RNA. Results: The study population consisted of 214 men (94.7%) and 12 women (5.3%) with a mean age of 35.6 ± 7.9 years. The most prevalent risk factor was imprisonment (88.9%) followed by injecting drug use (79.2%). The prevalence of HCV infection was 88.5% by ELISA and 86.7% by RIBA, while HCV viremia was detected in 26.1% of the patients. HCV-antibody positivity was significantly associated with gender, age, marital status, occupation, injecting drug use, and history of imprisonment. It was inversely related to "having an infected or high risk sexual partner". In the logistic regression model, the predictors of HCV-positivity were injecting drug use (OR = 24.9, P = 0.004) and imprisonment (OR = 21.4, P < 0.001). Conclusions: Prevalence of HCV infection among HIV-positive individuals in our region is very high and there is a need for stricter preventive actions against transmission of HCV among this group of patients

Surgical Ovulation Induction in Women with Polycystic Ovary Syndrome: A Systematic Review

Background: Currently clomiphene citrate is the first-linetreatment to induce ovulation in women with polycystic ovariansyndrome (PCOS). Surgical therapy with laparoscopicovarian drilling (LOD) may avoid or reduce the need for gonadotropins.Objective: To determine the effectiveness and safety of LODcompared with ovulation induction in subfertile women withclomiphene-resistant PCOS.Search Strategy: A systematic search was performed on Pub-Med (1966 to August 2007), the Ovid database (1966 to August2007), and EMBASE (1974-2007). The search terms included:infertility, menstrual disorder, hirsutism, PCOS, surgical intervention,electrocautery, electrocoagulation, diathermy, drilling,and laparoscopic ovarian drilling, ovulation, pregnancy rate,post operation adhesions and ovarian blood flow.Selection Criteria: Randomized controlled trials of womenwith clomiphene-resistant PCOS who were treated with LODto induce ovulation were included.Data Collection and Analysis: 3141 patients from 35 trialspreformed in different geographic settings were included. Alltrials were assessed for quality criteria. We included those trialswhich followed hormonal changes, ovulation, and pregnancyrates after LOD. The primary outcomes measured werehormonal changes, ovulation, and pregnancy rates as well asovarian artery blood flow, and the secondary outcome was rateof pelvic organ adhesion.Main Results: The overall ovulation rate after LOD was79.2% (74.9%-83.5% 95% CI). Of all women who ovulatedonly 66.6% (60.8%-72.4% 95% CI) conceived. The mean periadnexaladhesion rate was 22.7% (21.4%-24% 95% CI).Conclusion: Compared with medical therapy, LOD has manyadvantages including: to be done once, no need for intensivemonitoring, no chance of multiple pregnancy or ovarianhyperstimulation syndrome. LOD effectively decreases ovarianandrogens and improves folliculogenesis and increases chanceof ovulation and pregnancy rate. Finally, in vitro fertilisationshould be considered as the last resort

Analysis of survival data in thalassemia patients in Shiraz, Iran

OBJECTIVES: The survival rate of thalassemia patients has not been conclusively established, and the factors associated with survival remain unclear. This study aimed to determine the survival rate of thalassemia among patients in southern Iran and to identify the factors associated with mortality from thalassemia. METHODS: This retrospective cohort study was conducted based on a retrospective review of the medical records of 911 beta-thalassemia patients in 2014. Data analysis was conducted using the Kaplan-Meier method and Cox regression analysis. RESULTS: Overall, 212 patients (23.3%) died, and 26.8% had thalassemia intermedia. The 20-year, 40-year, and 60-year survival rates were 85%, 63%, and 54%, respectively. Both crude and adjusted analyses found that education, marital status, ferritin levels, and comorbidities were related to mortality. CONCLUSIONS: Sociodemographic and hematological factors were found to be significantly associated with the survival rate of thalassemia. Addressing these factors may help healthcare providers and physicians to provide the best possible care and to improve the survival rate