The Low Prevalence of Hepatitis C Virus and Human Immunodeficiency Virus Coinfection and Hepatitis C Virus Mono-Infection Among Methadone Toxicity Patients

the incidence of Hepatitis C Virus (HCV)and Human Immunodeficiency Virus(HIV) coinfection in People Who InjectDrugs (PWIDs) is a public health issue; itpresents various contentions to the healthcareproviders. Although antiretroviral therapy improvedthe life expectancy of HIV-infected people, HCV-relatedmortality turned into a greater concern among these individuals[1]. AccFurthermore, they mentioned, “injectingdrug users in the Taipei methadone maintenancetreatment program had a very high prevalence of HIV/HBV coinfection and HCV mono-infection”[2].Besides, a systematic review and meta-analysis resultssuggested a high frequency of HIV/HBV coinfection(>80%) in Intravenous (IV) drug users [3]. Althoughthe incidence of HIV among IV drug users has beendecreased, HCV is still endemic in this population [4].We aimed to estimate HCV/HIV coinfection frequencyand its related risk factors among methadone poisonedpatients who were admitted to the Loghman Hakim poisoningcenter between March 2012 and March 2017.Loghman-Hakim Hospital is a unique poisoning referralcenter in Tehran, Iran, that admits patients from all citiesin Tehran Province, Iran. Annually, around 20000 hospitalizedpatients are observed and treated in this center,with 80-100 patients daily turn-over.The required data were collected using a questionnaire,clinical examinations, and laboratory findings. The patientswith a history of infectious diseases, like hepatitisB or C, HIV, and IV drug consumption, were excludedfrom the present research. The obtained blood sampleswere screened for antibodies to HCV and HIV using acommercially available Enzyme-Linked ImmunosorbentAssay (ELISA). Furthermore, the relevant urine sampleswere analyzed for the presence of methadone with a rapidtest. Among 200 participants, 134 (67%) were male, and66 (33%) were female with the age range of 1 to 83 years.The methadone serum levels of 129 (64.5%) patients werepositive, 39 (19.5%) were negative, and 32 (16%) patientswere not examined due to the short duration of hospitalization(i.e. <2 days). Underlying diseases, such as noncommunicablediseases (11%), psychotic disorders (1.5%), andrespiratory disease (3.5%) were detected in 30 cases. ReactiveHCV-antibodies, active HIV-antibodies, and HIV/HCV coinfection were observed in 10 (5%), 2 (1%), and 2(1%) of the study subjects, respectively. Figure 1 shows theprevalence of HCV and HIV infection by gender and age

Frequency of Influenza-A-H1N1 in Patients with Community-Acquired Pneumonia Admitted to Loghman Hakim Hospital

Background: Here we assessed the incidence of Influenza-A-H1N1-related pneumonia in community-acquired pneumonia (CAP) at Loghman Hakim Hospital, Tehran, Iran.Materials and Methods: In this prospective study from November 22, 2016, to June 21, 2017, patients with CAP and suspected to seasonal influenza were included. Rapid Antigen test and quantitative real-time PCR assay were performed on samples. P-value < 0.05 was considered significant. In addition, radiologic patterns of them were evaluated.Results: a total of 29 admitted CAP patients were suspected of seasonal influenza. Two cases out of them were positive for influenza by real-time PCR, similar to result of influenza rapid test. The most common finding in their chest X ray was consolidation in one lobe. None of them vaccinated against influenza. Only nine patients received empiric Oseltamivir treatment. The amount of irrational antibiotic administration was significant.Conclusion: Despite low statistical numbers, admitted influenza CAP patients did not have unusual symptoms and radiologic patterns. Other results in this study showed need for antibiotic stewardship program and better training about necessity of vaccination

A Survey of the Protective Effect of Vitamin B6 on Linezolid-Associated Hematological Dyscrasia: Vitamin B6 and linezolid hematological toxicities

Hematological toxicities are considerable side effects of linezolid, which can restrict its administration. This study aims to evaluate the protective effect of vitamin B6 on linezolid-induced hematological dyscrasia, i.e., thrombocytopenia and anemia in poisoned patients. In this quasi-experimental (non-randomized, non-blinded) study, a number of 28 patients treated with linezolid and vitamin B6 were matched with 50 patients who received only linezolid. The hematological factors, including red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), and platelets (PLTs) were assessed at baseline and on days 0, 1, 3, 5, and 7 during the linezolid treatment coarse. There were no considerable differences between the two groups in demographic characteristics, poisoning, vital signs, baseline laboratory test results, and mortality rates. Overall, patients who received linezolid+B6 had significantly higher RBCs, Hb, and Hct than those treated with linezolid alone (P < 0.05). Unexpectedly, patients in the treatment group had lower PLT counts compared to the control group with no significant differences (P > 0.05). According to our findings, the co-administration of vitamin B6 and linezolid was accompanied by a lower risk of anemia but no impact on preventing or reducing thrombocytopenia in patients with gram-positive bacterial infections

Risk Factors of Hospital-acquired Thrombocytopenia in Toxicological Intensive Care Unit: Thrombocytopenia in Toxicological Intensive Care Unit

Background: Platelet count is a readily available biomarker predicting disease severity and risk of mortality in the intensive care units (ICU). This study aims to describe the frequency, to assess the risk factors, and to evaluate the impact of thrombocytopenia on patient outcomes in a Toxicological ICU (TICU).Methods: In this prospective observational Cohort study, we enrolled 184 patients admitted to our TICU from October 1st, 2019, to August 23rd, 2020. Mild/moderate and severe thrombocytopenia were defined as at least one platelet counts less than 150×103/µL and 50×103/µL during the ICU stay, respectively.Results: Of 184 enrolled patients, 45.7% had mild to moderate thrombocytopenia and 5.4% had severe thrombocytopenia. Old age (OR: 1.042, 95%CI: 1.01-1.075, P=0.01), male gender (OR: 4.348, 95%CI: 1.33-14.22, P=0.015), increased international normalized ratio (INR) levels (OR: 3.72, 95%CI: 1.15-112, P=0.028), and administration of some medications including heparin (OR: 3.553, 95%CI: 1.11-11.36, P=0.033), antihypertensive drugs (OR: 2.841, 95%CI: 1.081-7.471, P=0.034), linezolid (OR: 13.46, 95%CI: 4.75-38.13, P<0.001), erythromycin (OR: 19.58, 95%CI: 3.23-118.86, P=0.001), and colistin (OR: 10.29, 95% CI 1.44-73.69, P=0.02) were the risk factors of hospital-acquired thrombocytopenia. The outcomes of patients with normal platelet count were significantly better than those who developed thrombocytopenia (P<0.001).Conclusion: We found that thrombocytopenia could develop in almost 50% of patients admitted to TICU, which is associated with poor prognosis. Additionally, the platelet counts should be closely monitored to administer some medications (heparin, antihypertensive drug, and linezolid), especially in old patients