Prevalence of HIV Infection among Hemodialysis Patients

Human immunodeficiency virus (HIV) belongs to human retrovirus family and transmitted by blood transfusion and blood products. 36.9 million People were living with HIV infection worldwide in 2014 approximately1, during which 2 million (1.9–2.2 million) new infections with HIV had occurred. End-stage renal disease (ESRD) patients treated by hemodialysis (HD) are more susceptible for infection by human immunodeficiency virus infection. Renal failure can be an associated condition or could be a direct consequence of HIV infection2,3. Advanced HIV disease which is indicates by a low CD4 cell count is development of renal diseases subsequently4, however many other causes now may cause renal failure in patients with HIV, including drug-induced toxicity, hypertensive nephroangiosclerosis, and diabetes5. HIV infection and hemodialysis have same consequences such as cardiovascular diseases, immunosuppression, anemia, weight loss, and osteodystrophy6,7.Compared with rate of infection with other viral infection such as hepatitis B virus (HBV) or hepatitis C virus (HCV), the risk of HIV infection among hemodialysis patients is lower as the contact with contaminated sources.Although intensive HIV research has been done for 20 years, we have a little knowledge about mortality risk factor in ESRD on HIV-infected patients. Hemodialysis patients who have HIV-infected are assumed to a high risk for death4.The finding the current study demonstrated the prevalence of HIV in hemodialysis patients which was conducted in 5 hemodialysis centers in Tehran province, Iran, in the 2016. All the enrolled participants were informed about study and written informed consent was obtained. Statistical analysis was performed by SPSS version 16 (SPSS Inc, Chicago, IL, USA). Among 360 patients, 213 (59.17%) of patients were men and 147 (40. 83%) were females; the mean age of patients was 53.43. HIV Ab was negative in all cases. This result has been confirmed in other studies as well8. The highest frequency for duration of dialysis is 1-5 years.Nowadays viral transmission via hemodialysis routes is controlled and limited since more effective screening of blood donor. Screening and early diagnosis of kidney disease will improve outcomes in patients with HIV infection.Considering all of these evidences, further studies are recommended strongly to evaluate the real prevalence of HIV in these patients

Bacterial Infection of Pacemaker in Patients with Endocarditis

Background: The advancement of technology in recent decades has been lead to use the electrophysiology cardiac devices. Although these devices are used increasingly, but the frequency of subclinical infection is unknown. We investigate bacterial infections due to implantable cardioverter defibrillator (ICDs) in patients with endocarditis.Materials and Methods: Population of the study was considered among all adult patients in whom the cardiac electrophysiology device was removed. Associated infection endocarditis defined by the Duke criteria. 35 pacemakers (PM) were aseptically removed from these patients during January 2012 to November 2014. Intraoperative swabs from the different part of devices were collected, cultured in BHI (Brain Heart Infusion Broth) and then bacterial classical cultures were done under aerobic and anaerobic conditions. Biochemical and differential media were used to detect the bacteria species. Data analysis was performed by using SPSS version 16 software.Results: 13 cases of 35 patients with endocarditis diagnosed by modified Duke Criteria and removed pacemaker had positive culture. Of the 13 cases with infection 43% were identified as gram positive and 57% had gram negative bacteria.Conclusion: Based on our study and similar studies, bacteria can colonize in electrophysiology devices which can lead to bacterial infections.

Schizophrenia: The Dark Side of Toxoplasmosis

Toxoplasma gondii is an intracellular parasite that has been associated with several mental disorders. It usually causes an inapparent primary infection. Found worldwide, T. gondii is capable of infecting virtually all warm-blooded animals.1-3Schizophrenia is a neurological disorder characterized with long-term and devastating neuropsychological problems, usually presenting in adolescents or young adults. The disease affects almost 1.1% of the global population including all races and ethnic groups with an equal prevalence in both sexes.1 T. gondii seroprevalence is strongly associated with 12-month generalized anxiety disorder but not with other anxiety, depressive, or alcohol-related disorders. Because of the intracellular nature of some parasites, their treatment and development of new drugs is a major challenge for scientists.4 Recently, the use of nanoparticles and nano-scaffolds has suggested for the treatment of parasitic diseases, although limited research has been done in this regard.5-

Imported Malaria in an Iraqi Immigrant to Iran: Relevance for the Maintenance of Elimination Status

Background: Effective malaria control strategies require an accurate understanding of the epidemiology of locally transmitted Plasmodium species. Emerging evidence indicates that migrants from malaria endemic regions are at risk of delayed presentation of Plasmodium spp. and malaria infection.Cases Report: We reported a case of P. vivax malaria occurring after arrival in Iran. Patient was originally from Iraq. A 48-year-old male patient who was hospitalized with fever attacks, chills, and headache after arriving from Iraq to Tehran.Conclusion: In this patient, new prevention and screening strategies should be studied and blood safety policies adapted. Thus, ultimate elimination of malaria in Iran will require national malaria control program to adopt policy and practice aimed at all human species of malaria since neighbor country are still face to problem to control of malaria

Fungal Central Nervous System Infections in Patients With COVID-19

Recent studies have indicated that fungal co-infections have a major impact on the morbidity and mortality of patients with COVID-19. In these patients, the excessive production of inflammatory cytokines and the reduction in CD4 + T and CD8 + T cell count entails susceptibility to fungal infections.1 In addition to impaired cell-mediated immunity, comorbidities and immunosuppressive medications have a significant role in the development of fungal infections and have serious impacts on clinical outcomes.1-

Drug Resistance of Acinetobacter in Selected Hospitals

Background: Nowadays, nosocomial infection with multidrug-resistant Acinetobacter is an important problem in the world, which is facing wide spectrum antibiotics and hence has become resistant.Materials and Methods: In this study, positive cultures of Acinetobacter from one hundred clinical samples in seven hospitals from Tehran during 2012-2013 were collected for checking antibiotic susceptibility. Samples test with Ceftazidim, Cefepime, Amikacine and Imipenem by E-test and for Tazocin, Colistin and Tigecycline was performed with disk diffusion method.Results: For Colistin 10 samples, and for Tazocin, 40 samples were performed by E-test method. Then boumannii species of bacteria and non-baumannii Acinetobacter were separated by PCR and antibiotic susceptibility testing was performed on them. 89% of Acinetobacter samples were boumannii species, which was isolated from respiratory secretions at ICU.Conclusion: Boumannii and non-boumannii species of bacteria with a high percentage were resistant to Ceftazidim, Amikacine, Cefepime, Tazocin and Imipenem. All baumannii and non-boumannii Acinetobacter were sensitive to Colistin, were only 75% sensitive to Tigecycline, which is a new glycylcycline. Colistin and Tazocin results in samples limited to the E-test method were similar with disk diffusion

Destructive effects of citric acid, lactic acid and acetic acid on primary enamel microhardness

Objective: This study aimed to assess the destructive effects of citric acid, lactic acid and acetic acid produced from the fermentation of foods on primary teeth enamel.Methods: This in vitro, experimental study was conducted on 24 sound primary teeth. The teeth  were polished with a fine abrasive paper under running water. Tooth pieces measuring 3×4×3mm were cut out of the teeth and stored in 100% humidity until the experiment. The specimens were divided into 3 groups (n=8) and immersed in acetic acid, citric acid and lactic acid, respectively. The enamel microhardness of specimens was measured by Vickers microhardness tester at baseline and 5 and 30min after immersion in the freshly prepared acid solutions.Results: Repeated measures ANOVA showed that the effect of immersion time on microhardness was significant (p<0.001). Pairwise comparison among 0, 5 and 30 minutes time points using Bonferroni adjustment showed significant differences in microhardness at different time points (p<0.001). Evaluation of the effect of type of acid on microhardness revealed that the microhardness was not significantly different in the three groups of acids (p=0.915). Among the three understudy acids, only the reduction in microhardness from time 0 to 30 minutes was significantly different between lactic acid and acetic acid (p=0.042).Conclusion: Citric acid, lactic acid and acetic acid were all capable of demineralization and reduction of enamel microhardness. A significant difference existed in the demineralization potential of acids (the highest for lactic acid). However, this effect was more significant early after exposure

Frozen embryo transfer: Endometrial preparation by letrozole versus hormone replacement cycle: A randomized clinical trial

Background: The endometrial preparation with stimulating natural cycles for frozen embryo transfer (FET) have benefits like lower cost and ease of use. Objective: Comparing the clinical outcome of letrozole versus hormone replacement (HR) for endometrial preparation in women with normal menstrual cycles for FET in artificial reproduction techniques. Materials and Methods: A total of 167 participants who had frozen embryos and regular ovulatory cycles were randomly divided into two groups for endometrial preparation. One group (82 women) was stimulated with letrozole 5mg/day and the other group (85 women) was hormonally stimulated by oral estradiol valerate (2 mg three times a day). All participants were followed serially by ultrasonography. Any patient who did not reach optimal endometrial thickness was excluded from the study. Implantation, biochemical and clinical pregnancy and abortion rate were reported. Results: There was no significant difference in the mean age, duration, and primary or secondary infertility, cause of the infertility, number, and quality of transferred embryos between the groups. The mean estradiol level on the day of transfer was 643 ± 217 in the HR group and 547 ± 212 in the letrozole group (P = 0.01), which was significantly different. The clinical pregnancy rate was 38.7 in the letrozole group, higher than the HR group (25.3) but not significantly different (P=0.06). Conclusion: For endometrial preparation in women with a normal cycle, letrozole yields higher pregnancy rate although it is not significant; due to its cost, ease in use, and lower side effects, letrozole is a good choice. Key words: Letrozole, Hormone replacement, Endometrial, Preparation, Frozen, Embryo