Persistence of immunity to hepatitis B vaccine as infants, 17 years earlier

Background: In Iran since 1992, hepatitis B vaccination was a part of the national vaccination program. Hepatitis B vaccination is effective in the epidemiology of hepatitis B. The aim of this study was to evaluate the long – term persistence of immunity. Methods: This cross-sectional analytical study was conducted on children and adolescents aged between 6-18 years in Birjand, who received a three – dose hepatitis B vaccination in accordance with the national immunization program. No students were infected with hepatitis B. Antibody titer higher than10 IU/L was considered positive. Results: A total of 530 patients (307 boys and 223 girls) were recruited for the study of which 44% had positive antibody titer (≥10 IU / L). The geometric concentration mean (GMCs) of antibody in subjects was 64.9±34.2, HBS antibody titer was positive in 40.4% of the boys and 59.6% of the girls. A significant difference in antibody titers was observed in terms of gender and according to the time elapsed since the last vaccination. Antibody titer in children older than 13 years had passed since their last vaccination and was significantly less than those children younger than thirteen years old had passed since their vaccination logistic regression analysis showed that the only predictive factor of anti-HBS low titer (<10 IU/L) is elapsed time of vaccination. Conclusions: Based on results of this study, hepatitis B vaccine has created a good level of protection in 44% of the adolescents after 17 years

Surveying Birjand faculty members’, paramedical and nursing students\\\' viewpoints on educational evaluation plan

Background and Aim: The aim of educational evaluation is to improve learning and create a suitable situation for academic staff. The present study was performed to assess the viewpoints of BUMS teachers and students regarding the evaluation plan and the effect of it on educational development. Materials and Methods: The present study was a cross-sectional and descriptive-analytical one. It was performed in the second half of the academic year 2008-9 in Birjand University of Medical Sciences. The study sample included 79 faculty members and 321 paramedical and nursing students. Their opinions were separately studied using two questionnaires for students and faculty members. Content validity and reliability of the two questionnaires employed were confirmed by respective specialists. The gathered data was analyzed by means of SPSS software (V: 16) and Chi-square at the significant level α≤0.05. Results: It was found that 76 % of faculty members believed that evaluation had some positive effects leading to the betterment of the process of teaching. But, %74.7 of them believed that some changes in the process should take place. Besides, %69.9 of the faculty members thought that the questionnaires were irresponsibly and carelessly filled out by the students. On the other hand, %59.5 of the students believed that the results of the evaluation were not considerably taken into account. They believed that evaluation forms were not suitable evaluative means for teaching. Conclusion: The results of the present study showed that most of faculty members and students are not optimistic about evaluation plan. Therefore, assuring students and teachers of the effectiveness of evaluation regarding the improvement of educational condition will result in more responsibility in students and more motivation in their teachers

Cardiovascular Risk Factors and Atherogenic Indices in an Iranian Population: Birjand East of Iran

Introduction: The alteration in serum lipid profile; increase in total cholesterol (TC), triacylglycerol (TAG), and low-density lipoprotein cholesterol (LDL-C); and reduction in high-density lipoprotein cholesterol (HDL-C) are key factors in cardiovascular disease progression. The high prevalence and severity of cardiovascular diseases require new screening tools for better evaluation. Atherogenic index (AI) (LDL-C/HDL-C) and coronary risk index (CRI) (TC/HDL-C) can be strong markers for predicting the risk of atherosclerosis and coronary heart disease and disclose the presence of LDL or TAG in the serum of related patients. To implement this strategy, the AIs and CRIs in our population were assessed. In this study, a total of 5207 subjects were recruited and AIs and CRIs were calculated for all of them. According to our data, age, body mass index, sex, as well as CRI and AI had affirmative correlation with TC, LDL-C, TAG, systolic blood pressure, and diastolic blood pressure. By increasing these factors, AIs and CRIs were augmented. Moreover, in situations where all atherogenic parameters are normal, these parameters may be the alternative screening tool

Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease

Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion

Prevalence and determinants of hypertension among Iranian adults, Birjand, Iran

Background: Hypertension (HTN) is a major cause of noncommunicable diseases. In this study, we report the prevalence rate of HTN in Birjand population. Methods: This cross-sectional study was conducted on 1286 individuals in Birjand in 2014. Individuals with systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg were considered as hypertensive. Data were analyzed using Chi-square test, independent t-test, and one-way ANOVA.P < 0.05 was considered as statistically significant. Results: Among the 1286 participants, 659 were women (51.2%). Prevalence of HTN was 20.1% (10.3% systolic HTN and 6.9% diastolic HTN). Prevalence self-reported HTN was 12.3%. SBP and DBP means were higher in men (P < 0.001). Mean scores of SBP and DBP increased by aging and body mass index (P < 0.001). Diabetic individuals had higher SBP scores (P < 0.001). Dyslipidemic patients had greater SBP and DBP (P < 0.001). Conclusions: Prevalence of HTN in our study is high. About one-fifth of the participants had HTN. In addition, BP is higher in men, elderly, and diabetic individual. Therefore, it is necessary to control BP regularly in different groups in society

SARS-COV-2 IgG specific antibodies persistence in recovered COVID-19 individuals and its association with severity and time of illness

In order to accurately interpret the immune response to COVID-19, it is critical to know how long serum antibodies to COVID-2 persist. This study aimed to describe the serum IgG responses to SARS-CoV-2 in patients with mild, moderate, and severe COVID-19 infection in Birjand, South Khorasan province, Iran. The study was performed on individuals whose COVID-19 disease was confirmed by RT-PCR and recovered from the disease. After completing the questionnaire, blood samples were collected from 4 different groups based on the time of the test at two, four, six, and eight months' post-recovery. Then, SARS-COV-2 virus-specific IgG nucleocapsid antibody level in patients was measured using the enzyme-linked immunosorbent assay (ELISA). In total, 206 patients (mean age 44.19 ​± ​14.9, 51% man) were included in the survey. Serum prevalence of specific IgG antibodies in patients with mild, moderate, and severe COVID-19 disease was 51.5%, 64% and 78.9%, respectively. Furthermore, serum prevalence of COVID-19 specific IgG antibody level in two, four, six, and eight months after recovery were 80.8, 69.1, 43.2 and 41.8%, respectively (p ​ ​0.05). In the present report, we attempted to characterize the antibody response against SARS-CoV-2 in patients with mild, moderate, and severe COVID-19, with the aim of better elucidating the humoral immune response after recovery from SARS-CoV-2 infection

A multicenter study of severity and prognosis of symptomatic COVID‐19 in end‐stage renal disease and non‐dialysis patients in East of Iran

Abstract Objectives This study aimed to assess the severity and related factors of symptomatic COVID‐19 in end‐stage renal disease (ESRD) patients from several centers in Eastern Iran. Methods In this retrospective cohort study, after obtaining ethical approval, 410 patients diagnosed with COVID‐19 were included for analysis. Patients were categorized into two groups based on their dialysis status: the dialysis group (ESRD patients undergoing hemodialysis) and the non‐dialysis group (those without chronic dialysis). Demographic information, clinical symptoms, laboratory tests at admission, length of hospitalization, ICU admission, need for mechanical ventilation, and mortality data were extracted from their medical records and entered into researcher‐developed checklists. Results In this multicenter study, 104 dialysis patients with a mean age of 64.81 ± 16.04 were compared to 316 non‐dialysis patients with a mean age of 60.92 ± 17.89. Patients were similar in terms of age and gender, but a higher percentage of the dialysis group was aged over 65 years (p = .008). Altered consciousness, dyspnea, headache, myalgia, anorexia, and cough were statistically significantly more common in the dialysis group when evaluating clinical symptoms (p < .05). The dialysis group had significantly higher levels of white blood cell (WBC), potassium, calcium, urea, creatinine, blood pH, INR, ALT, ESR, and CRP, and lower levels of red blood cell, Hb, platelets, sodium, and LDH compared to the non‐dialysis group. Profoundly altered consciousness was more common among deceased patients (p < .001), and this group had higher WBC counts, urea levels, AST, ALT (p < .05), and lower blood pH (p = .001). Conclusion Based on the results of this study, it is plausible to suggest a hypothesis of greater severity and worse prognosis of COVID‐19 in ESRD patients. Underlying comorbidities, such as liver disorders or more severe clinical symptoms like altered consciousness, may also be indicative of a worse prognosis in dialysis patients with COVID‐19

SD1000: High Sustained Viral Response Rate in 1361 Patients With Hepatitis C Genotypes 1, 2, 3, and 4 Using a Low-cost, Fixed-dose Combination Tablet of Generic Sofosbuvir and Daclatasvir: A Multicenter, Phase III Clinical Trial

Background. The combination of sofosbuvir and daclatasvir is a potent, pangenotypic regimen suitable for mass-scale hepatitis C treatment, especially in resource-limited countries where newer, expensive combinations are not available. This combination has been widely tested on genotype 4. However, Phase III trials of this combination in other genotypes have been cost prohibitive. With the introduction of generic, low-cost sofosbuvir and daclatasvir, large-scale studies in resource-limited countries are now possible. Methods. Sofosbuvir at 400 mg and daclatasvir at 60 mg were coformulated into a fixed-dose combination (FDC) tablet (Sovodak, Rojan Pharma, Tehran, Iran). Patients from 46 centers were dosed for 12 or 24 weeks with or without ribavirin, in line with existing guidelines. Responses to treatment were evaluated 12 weeks after the end of treatment (for a sustained virological response at Week 12; SVR12). Results. There were 1361 patients recruited. Overall, the patients were 21% female, with a mean age of 50 years; 39% were cirrhotic; 22% were treatment-experienced; 47% were genotype 1, 41% were genotype 3, and 2% were other genotypes. The genotype was not known in 10% of the patients. The intention-to-treat and per-protocol SVR12 rates were 94.7% and 98.8%, respectively. The safety profile was unremarkable, treatment was well tolerated, and compliance with the single-tablet regimen was excellent. Conclusions. The treatment with FDC of sofosbuvir and daclatasvir achieved high SVR12 rates, equivalent to those seen in Phase III trials of other pangenotypic options, and has been conducted at a similar scale in a representative, real-world population at a cost of under $100 per patient, which makes this combination suitable for elimination protocols in resource-limited countries. Keywords:sofosbuvir; daclatasvir; Hepatitis C; sustained virological response; generic drug