HIV prevalence and risk behaviours among people who inject drugs in Iran: the 2010 National Surveillance Survey

Objectives To assess the prevalence of HIV and related risk behaviours among people who inject drugs (PWID) in Iran. Methods We conducted a national cross-sectional bio-behavioural surveillance survey between March and July 2010, interviewing male PWID from a geographically dispersed sample through a facility-based sampling method. Results We recruited 2480, and tested 2290 PWID. The overall prevalence of HIV was 15.2% (95% CI 9.7% to 23.1%). Among those who had injected drugs over the last month, 36.9% had used a non-sterile needle, and 12.6% had practiced shared injection. Over the past 12 months preceding the interview, 30.4% had sold sex for money, drugs, goods or a favour. In the multivariate analysis, the prevalence of HIV had a positive association with age, while having above high school education, and permanent job were protective. Conclusions Unsafe injection, and sexual risk behaviours are still frequent and the prevalence of HIV among PWID remains high. Intensified efforts are needed to prevent the further spread of HIV among Iranian PWID and their sexual partners

Postoperative Outcomes in Patients with Chronic Renal Failure Undergoing Coronary Artery Bypass Grafting in Madani Heart Center: 2000-2010

Introduction: Renal failure predisposes patients to adverse outcome after coronary artery bypass grafting (CABG). Renal dysfunction is a predictor of increased morbidity and mortality after CABG, whether it is dialysis-dependent or not. Methods: In a retrospective study from April 2000 to December 2010, seventy-six patients (60 male and 16 female with the mean age of 58.57±7.93 years) with different categories of chronic renal failure undergoing CABG in Shahid Madani Hospital, were studied. The cardiac disease leading to the operation was coronary artery disease (CAD) in all patients. Patients demographic, surgical and laboratory data were gathered from hospital records. Data were then analyzed. Results: Mean hospital stay was 10.16±7.16 days. The preoperative mortality rate was 10.5% (15% in non dialysis and 5.6% in dialysis dependant patients with no significant difference). Morbidity rate was 28.9% (respectively 30% and 27.8% in dialysis and non dialysis patients with no significant difference) including in-hospital myocardial infarction (MI) (10.5%), in-hospital stroke (2.6%), in-hospital bleeding (21.1%) and in-hospital infection, pneumonia, (5.3%). Mean creatinine and blood urea nitrogen (BUN) levels were significantly increased after surgery (p<0.001). Postoperative hemodialysis rate was 33.3%. Conclusion: Chronic renal failure whether dialysis-dependant or not increases in-hospital mortality and morbidity in patients undergoing CABG. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of postoperative dialysis