Gonor¬rhea and syphilis co-infection and related risk factors in HIV patients from Shiraz, South of Iran

Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonor¬rhea. Compared with mono-HIV infected patients, gonor¬rhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonor¬rhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonor¬rhea infected patients (368±238 vs. 415±328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs

Identification and Analytical Hierarchy of Effective Criteria in Optimal Location of Humidification-Dehumidification Desalination Plants

In recent years, water stress has become a global crisis due to climate and demographic changes and lifestyle changes. Freshwater production from the sea using various processes is known as the most important solution to deal with this crisis. Among these processes, the humidification-dehumidification process has been considered by the scientific community as a flexible and low-cost method. In addition, the optimal choice of construction sites for factories and even small water desalination units has a significant impact on increasing productivity and optimizing their construction and operation costs. In this study, using Delphi method, effective factors in locating humidification-dehumidification were identified. Then, using the Analytical Hierarchy Process, two decision support systems, one based on criteria and sub-criteria and the other by combining all sub-criteria, are proposed to locate this group of desalination plants. The results show that the factors of inlet air temperature (ambient temperature), incoming water temperature and relative humidity of the air from the technical criteria, with an effective weight of 0.186, 0.126 and 0.09, respectively, are the most important factors in locating this group of desalination plants. In the following, the factors of access to technical and engineering services and the amount of water reserves of the executive criteria, with a weight of 0.076 and 0.064, have been assigned the fourth and sixth ranks. Fresh water sales tariff, construction fee and cost of wastewater and waste disposal from economic criteria with the effectiveness of 0.069, 0.061 and 0.06, respectively, are in the fifth, seventh and eighth positions. Also, the annual average factor of solar energy from environmental criteria is in the ninth place with 0.054 points. These factors are the most effective factors in locating humidifiers-dehumidifiers

The Emergence of Qnr-resistance Among Klebsiella pneumoniae spp in Zahedan: Qnr-resistance Among Klebsiella pneumoniae spp

Although quinolone resistance results mostly from chromosomal mutations in Klebsiella pneumoniae, it may also be mediated by plasmid – encoded qnr determinants. Plasmid-mediated quinolone resistance (PMQR) was increasingly identified in Enterobacteriaceae family worldwide. The aim of this study was to investigate the prevalence of qnr genes in clinical isolates of Klebsiella pneumoniae spp in Zahedan, south-East of Iran. In this sectional-descriptive study which was performed in 2013, clinical isolates of k. pneumoniae (n=184) were collected from patients referred to 3hospitals of Zahedan. The presence of the qnr gene was screened by PCR using specific primers for qnrA, qnrB, qnrS and qnrC in extracted plasmid DNA. Of 184 K. pneumoniae clinical isolates, 45 isolates were positive for the qnr gene. The prevalence of qnrA, qnrB and qnrS clusters among these isolates were 8 (17.7%), 22 (48.8%), 4(8.88%) respectively and qnrC was not identified in any isolate. Another 6(13.33%) possessed both qnrA and qnrB genes and 5(11.11%) possessed both qnrB and qnrS. qnr are widely distributed worldwide. Community-acquired and nosocomial pathogens and the emergence of qnr-mediated quinolone resistance among clinical K.pneumoniae isolates are described for the first time in Iran

Clustering Undergraduate Students Based on Academic Burnout and Satisfaction from the Field Using Partitioning around Medoid

Background. Academic satisfaction is known as one of the most important factors in increasing students' efficiency, and academic burnout is one of the most significant challenges of the educational system, reducing student motivation and enthusiasm. Clustering methods try to categorize individuals into a number of homogenous groups. Aims. To cluster undergraduate students at Shahrekord University of Medical Sciences based on academic burnout and satisfaction with their field of study. Materials and Methods. The multistage cluster sampling method was used to select 400 undergraduate students from various fields in 2022. The data collection tool included a 15-item academic burnout questionnaire and a 7-item academic satisfaction questionnaire. The average silhouette index was used to estimate the number of optimal clusters. The NbClust package in R 4.2.1 software was used for clustering analysis based on the k-medoid approach. Results. The mean score of academic satisfaction was 17.70±5.39, while academic burnout averaged 37.90±13.27. The optimal number of clusters was estimated at two based on the average silhouette index. The first cluster included 221 students, and the second cluster included 179 students. Students in the second cluster had higher levels of academic burnout than the first cluster. Conclusion. It is suggested that university officials take measures to reduce the level of academic burnout through academic burnout training workshops led by consultants to promote the students' interests

The effects of zinc sulfate supplementation on serum copeptin, c-reactive protein and metabolic markers in zinc-deficient diabetic patients on hemodialysis: a randomized, double-blind, placebo-controlled trial

We aimed to investigate the association between zinc (Zn) supplementation and serum levels of copeptin, high-sensitive C-reactive protein (hs-CRP), glycemic control, anthropometric parameters and renal function in Zn -deficient diabetic hemodialysis patients (DHPs). This randomized, double-blind, placebo-controlled trial (RCT) was conducted on 46 DHPs with Zn-deficiency. The Zn supplement group (n = 21) received a 220-mg/day Zn sulfate capsule (containing 50 mg Zn), and the control group (n = 25) received a placebo capsule (220 mg corn starch), for 8 weeks. Fasting, predialysis blood samples were taken at baseline and after 8 weeks to assess fasting blood glucose (FBG), serum insulin, copeptin, high-sensitive C-reactive protein (hs-CRP), blood urea nitrogen (BUN), creatinine (Cr) concentrations, and homoeostatic model assessment (HOMA-IR) and quantitative insulin-sensitivity check index (QUICKI). Compared to controls, serum copeptin (P < 0.001), hs-CRP (P < 0.001), BUN (P < 0.001), Cr (P < 0.001), Zn (P < 0.001), FBG (P < 0.001) levels, BMI (P < 0.001), and body weight (P < 0.001) were significantly affected following ZnSO4 supplementation for 8 weeks. In contrast, QUICKI (P = 0.57), HOMA-IR (P = 0.60), and serum insulin (P = 0.55) were not affected following Zn supplementation in comparison with patients receiving placebo. Zn sulfate supplementation appears to have favorable effects on serum copeptin and hs-CRP, FBG, and renal function in Zn-deficient DHPs. Iranian Registry of Clinical Trials Identifier: IRCT20190806044461N

COVID-19 Pandemic is Not Over for Survivors with Long COVID Syndrome: Evidence of a One-Year Retrospective Follow-up Study from Iran

Background: Most patients who are infected by COVID-19 develop recovery from it; however, some of these patients experience a variety of mid-and long-term physical and/or mental effects after their initial illness recovery. These mid and long-term effects are collectively known as post-COVID-19 conditions or “long COVID.” Objectives: We aimed to detect the incidence of long COVID syndrome (LCS) and its determinants. Methods: In this retrospective cohort study, previously hospitalized subjects due to COVID-19 were selected by systematic random sampling. A valid checklist was filled out by phone interview with each participant, while hospitalization data were extracted from hospital information system. Data were analyzed using SPSS software. Results: The mean age of 1,738 interviewees was 54.2 ± 14.5 years. The median time of follow-up was 352 days. Overall, 1,526 (87.8%) interviewees had at least one symptom of LCS. Among physical symptoms, hair loss (23.9%) and among psychological complaints, depression (69.1%) were predominant. Anemia (odds ratio (OR): 3.22, 95% confidence interval (CI): 1.49-6.98), patients of second epidemic wave (OR: 2.82, 95% CI: 1.57-5.07), use of vitamins/minerals (OR: 2.25, 95% CI: 1.53-3.3) or antibiotics (OR: 1.84, 95% CI: 1.02-3.33), diabetes mellitus (OR: 1.9, 95% CI: 1.11-3.23), who were not the head of their families (OR: 1.65, 95% CI: 1.18-2.32) and use of antivirals (OR: 1.64, 95% CI: 1.03-2.61) were significantly associated with LCS. Conclusions: COVID-19 pandemic is not over, and most COVID-19 survivors suffer from LCS. Therefore, the establishment of integrated post-COVID care systems for these patients is highly needed and recommended