Non- adherence to anti-retroviral medication in Shiraz, 2014: a cross sectional study

Background: Medication adherence is a dynamic and complex behavioral process, which is strongly influenced by personal, social and environmental factors.Objectives: To determine the prevalence and factors affecting non-adherence to medication among HIV-infected patients.Methods and materials:Design: A cross-sectional study.Setting: Voluntary Counseling and Testing Center (VCT), Shiraz, Fars province, in the South of Iran.Patients: Among HIV-positive patients who received anti-retroviral therapy, 214 adult patients were selected through convenience sampling. Their medication adherence was checked by interview and counting the pills on visits during two months. Clinical and laboratory data were obtained from the patients' records.Results: Non-adherence and adherence groups included 30.4% (65) and 69.6% (149) of the patients, respectively. The mean age of patients was 40.80±7.77 years, and ranged from 20 to 65 years. Majority of cases (65%) were male. A significant relationship was found between non-adherence to medications and the variables of transmission method, marital status, housing status, and CD4, but there was no significant relationship with gender.Conclusion: The prevalence of medication adherence was similar to other regions with limited financial resources. To increase patient’s medication adherence, they should be exposed to motivational interventions to promote their drug consumption, social and occupational support.Keywords: Prevalence, adherence, anti-retroviral medication, HIV

Non- adherence to anti-retroviral medication in Shiraz, 2014: a cross sectional study

Background: Medication adherence is a dynamic and complex behavioral process, which is strongly influenced by personal, social and environmental factors. Objectives: To determine the prevalence and factors affecting non-adherence to medication among HIV-infected patients. Methods and materials: Design: A cross-sectional study. Setting: Voluntary Counseling and Testing Center (VCT), Shiraz, Fars province, in the South of Iran. Patients: Among HIV-positive patients who received anti-retroviral therapy, 214 adult patients were selected through convenience sampling. Their medication adherence was checked by interview and counting the pills on visits during two months. Clinical and laboratory data were obtained from the patients' records. Results: Non-adherence and adherence groups included 30.4% (65) and 69.6% (149) of the patients, respectively. The mean age of patients was 40.80\ub17.77 years, and ranged from 20 to 65 years. Majority of cases (65%) were male. A significant relationship was found between non-adherence to medications and the variables of transmission method, marital status, housing status, and CD4, but there was no significant relationship with gender. Conclusion: The prevalence of medication adherence was similar to other regions with limited financial resources. To increase patient\u2019s medication adherence, they should be exposed to motivational interventions to promote their drug consumption, social and occupational support

Dermatological manifestations of HIV/AIDS individuals in Shiraz, South of Iran

Introduction: HIV infection remains as a major challenge facing medical sciences in the world today. Mucocutaneous manifestation was first observed in patients with HIV/AIDS in the early 1980s. The aim of this study was to identify various skin manifestations based on making careful clinical observations and performing the necessary tests. Materials and Methods: A total of 240 patients whose disease was diagnosed using WB and ELISA tests, with dermatologic manifestations and were older than 18 years, participated in this study. These patients had referred to the voluntary counseling and testing center in Shiraz for routine examinations. Results: From the total of 240 participants, 158 were males (65.8%) and 82 were females (34.2%). The mean age was 40.87 ± 8.04 years. Dermatologic manifestations were of infectious origin in 79 (33%) of the participants. As the most common viral skin infections, herpes simplex was seen in 16 patients (6.7%), with herpes zoster ranking second with 15 patients (6.3%). No relationship was found between CD4 cell count and infectious or noninfectious dermatologic manifestations (P = 0.274). Conclusion: No association was found between CD4 cell counts and dermatologic manifestations. Many skin disorders may appear in HIV/AIDS patients with normal CD4 cell counts

Terbutaline versus salbutamol for suppression of preterm labor: A randomized clinical trial

Background and Objective: Preterm labor (PTL) is a common medical problem during pregnancies and is associated with neonatal mortality and morbidity. Beta-adrenergic agonists are among the most commonly used tocolytic agents. The aim of this study was to compare the effectiveness, safety and adverse effects of terbutaline with those of salbutamol in the prolongation of pregnancy beyond 48 hours and until 37 weeks of gestation. Patients and Methods: Two hundred women with PTL were randomly assigned to receive subcutaneous terbutaline (250 μg) or intravenous salbutamol (0.1 mg) followed by oral terbutaline (20 mg/d) or oral salbutamol (24 mg/d) as maintenance. The efficacy, side effects and complications after 48 hours and until 37 weeks of gestation were analyzed and compared. Results: There was no significant difference between the two groups in success rate within 48 hours (P= .091). Gestational age at delivery (P=.031) and the number of days for which the gestation was prolonged (P=.024) were significantly higher in those receiving terbutaline. Adverse effects, including tachycardia (P=.007) and anxiety (P=.006), were experienced more in the salbutamol group. Birth weight was significantly lower in the salbutamol group (P=.001). Conclusion: Terbutaline provided more effective tocolysis with fewer adverse effects and a better neonatal outcome. However, terbutaline and salbutamol are equally effective in the first 48 hours

The effect of sperm morphology on IUI outcome in cases with unexplained and male factor infertility

Background: Although intrauterine insemination (IUI) is one of the most common methods which is used for male factor and unexplained infertility, the relative influence of various semen parameters on the likelihood of a successful outcome is controversial. Several semen parameters have been evaluated as predictors of a successful outcome with intrauterine insemination. Objective: To evaluate the effects of sperm morphology on the success rate of IUI. Materials and Methods: This was a prospective study of 200 couples who underwent IUI cycles of ovarian stimulation in Shiraz University of Medical Sciences. The patients were chosen in 2 groups, group A: 100 patients with ≤20% normal sperm morphology and group B: 100 patients with >20% normal sperm morphology (unexplained infertility). The other semen parameters were normal in both groups. Results: Total clinical pregnancies were 10.5% (pregnancy rate / cycle). There was not any difference between two groups in rate of pregnancy and also pregnancy outcome. Conclusion: Intrauterine insemination used for treating male factor infertility has not shown excessive advantage when normal sperm morphology in semen analysis is more than 20% in comparison with ≤ 20%

Metabolic syndrome and its associated factors in Shiraz Heart Study (A cohort-based cross-sectional study)

Background and Aims: Metabolic syndrome (MetS) with modifiable and non-modifiable risk factors is an increasing global concern. It predisposes individuals to a significant cardiovascular risk that is the leading cause of death in Iran. We investigated MetS prevalence and its risk factors in Shiraz, Iran. Methods: 7225 participants in the age range of 40 to 70 years were recruited from the Shiraz Heart Cohort Study. MetS was diagnosed according to the Adult Treatment Panel III definition. The trend test, univariate, and multiple logistic regression were performed via SPSS version 16 at 0.05 significance level. Results: Among the cases, 3780 (52.3 %) were female, and more than 73.4 % were overweight or obese. MetS prevalence in Shiraz is estimated around 45.5 % (95% CI: 44.4 - 46.7%), and female odds were 1.91 times more than males. Participants with low physical activity had nearly twice the risk of metabolic syndrome in comparison to individuals with high physical activity. The univariate logistic regression showed that age, gender, job, education, marital status, and physical activity are significantly associated with MetS. Conclusions: The prevalence of MetS in the Shiraz urban population is relatively high and has become more common amongst middle-aged people, which can significantly endanger public health. Since most of the risk factors are modifiable, it is imperative to set policies in order to control MetS and its associated risk factors

Clinical Outcome of Vancomycin-Resistant Enterococcus Colonization Among Liver Transplant Recipients at Shiraz Organ Transplant Center

Objectives: Liver transplant recipients are more susceptible to vancomycin-resistant enterococci colonization than healthy individuals. We investigated the prevalence of vancomycin-resistant enterococci colonization and its effect on the outcomes of liver transplant recipients. Materials and Methods: Patients who had undergone primary liver transplant at the Shiraz Organ Transplant Center from 2015 to 2017 were enrolled in this study. Demographic characteristics, laboratory test results, duration of stay in the intensive care unit, total duration of hospital stay, and clinical outcome data were extracted from the Shiraz Organ Transplant Center database. Posttransplant outcomes such as graft rejection, mortality, hospital stay, and kidney function tests were included for the first 90 days after transplant. Results: A total of 753 liver transplant recipients (470 males and 283 females) were included in this study. Vancomycin-resistant enterococci colonization was identified in 51 patients (6.8%) after transplant at the time of intensive care unit admission. Our study found no significant difference between outcomes for patients with vancomycin-resistant enterococci colonization and outcomes for patients without colonization, including graft rejection, mortality, hospital stay, and kidney function tests. Conclusions: Our study revealed that asymptomatic vancomycin-resistant enterococci colonization in liver transplant patients has no adverse effect on the duration of posttransplant hospital stay, early mortality rate, graft rejection rate, or kidney function compared with noncolonized patients