Mental Health among People Living with HIV (PLWH) in Iran: A Policy Brief Teaser: The necessity of a Tool for Mental Health in PLWH in Iran

Depression and anxiety are the most common mental health disorders in people living with HIV (PLWH). Adherence to antiretroviral therapy (ART) is an important concern that could be significantly affected by psychological problems among PLWH. Therefore, the authors recommend using an anxiety and depression screening tool, among Iranian PLWH in HIV health care system and determine potential barriers to depression screening and effective care

Frequency of HIV Infection among Sailors in South of Iran by Rapid HIV Test

Information on the prevalence and risk factors for HIV infection among sailors is scarce. The aim of this seroprevalence study was to evaluate the frequency of HIV infection among sailors in south of Iran using rapid HIV test. The study included 400 consecutive participants in Lengeh, Shahid Rajaie, and Shahid Bahonar ports in south of Iran in May 2010. We observed only one case (0.25%) of HIV infection in this sample of sailors. While prevalence appears low at present, we recommend periodic HIV serosurveillance with detailed behavioral measures for this population in the future

Zika virus: A review of literature

AbstractZika virus (ZIKV) has two lineages: African and Asian. Mosquito-borne flaviviruses are thought to replicate initially in dendritic cells and then spread to lymph nodes and the blood stream. Risk for infection through blood transfusion, sexual practices and perinatal transmission exists. The possible routes of perinatal transmission are during delivery, breastfeeding and by close contact between the mother and her newborn. Also, mucocutaneous exposures to the virus by infected blood or monkey bite, organ transplantation or hemodialysis are the other routes of ZIKV transmission. There are two types of ZIKV infection; Zika fever and congenital infection. Clinical presentation of Zika fever varies from asymptomatic infections to a self-limiting febrile disease with low grade fever, conjunctivitis, maculopapular rash, headache, retro-orbital pain and arthritis/arthralgia with periarticular edema, myalgia, vertigo, vomiting and asthenia. This clinical feature could be mistaken for dengue or chikungunya fevers. Microcephaly is the most important and frequently reported clinical picture of suspected congenital Zika syndrome. Laboratory tests are needed for diagnosis of ZIKV infection, because there is no known pathognomonic clinical, biochemical or radiological features. RT-PCR is the most well-liked assay. Serum samples are tested by immunoglobulin G ELISA with ZIKV antigen. Samples are also tested by immunoglobulin M ELISA. There is no certified vaccine or therapeutic medication. In asymptomatic or uncomplicated patients, treatment is not necessary

Content Analysis of Teleconsultation Enquiries in Positive Health Club, Imam Khomeini Hospital, Tehran, Iran

Objective: With the availability of specialists and the overflowing information in public and social networks, individuals have easy access to information about HIV and AIDS. However, medical counselling and healthcare settings still have an essential role. The aim of the present study was to analyze phone enquiries directed to the Positive Club of Imam Khomeini Hospital in Tehran; this analysis was based on demographic features of participants.Design/Methodology/Approach: In this cross-sectional study, 5255 questions were extracted and coded from the Positive Club's counselling questionnaires; the coding procedure was based on Huber and Gilapsy's decimal classification. Data were processed by descriptive statistics and SPSS software.Findings: A majority of callers were men (59.43%), most callers were aged between 26 and 30 years, and HIV transmission and high-risk sexual behaviours were among frequently asked questions (47%).Originality/Value: Taking into account that most callers were concern about transmission via sexual contact (anal, vaginal, and oral) rather than injection and its related equipment, it seems reasonable to assume that HIV transmission flow may shift from shared injection equipment to high-risk sexual behaviors

An Estimation of HIV/AIDS’s Cost in the Voluntary Counseling and Testing Center of Imam Khomeini Hospital in 2010-2011

Introduction: Undoubtedly, HIV/AIDS is one of the most important emerging infectious disease in the late twentieth century; and its control is possible only with proper and organized program. To attain this goal, one of the most serious issues is the budget planning and distribution. The present study calculated the total costs of AIDS in Voluntary Counseling and Testing center of Imam Khomeini Hospital in 2010-2011.Methods: The total cost of AIDS at this center was divided into four categories: health care, training and educating, research and services. All costs for 2010-2011 were extracted and classified based on documents and bills which were found in the center.Results: According to the calculations, the center had a total of 6,603,479,058 IRR in 2010-2011, of which 49.5% (3,271,089,796 IRR) was allocated for health care expenditure, 20.3% (1,335,186,000 IRR) for research, 12.6% (834,000,000 IRR) for training and 17.6% (1,163,203,262 IRR) for services. The average expense for each person living with HIV was 2276 US dollars. The cost of treatment by drugs for each person eligible for treatment was 782 US dollars.Conclusion: The percentage of budget distribution in the center is equal to the same percentage in low and middle income countries; although, more percentage is allocated for research than the mentioned countries. Also, the expenditure spent for treatment by drugs is more than the average of the same found in low and middle income countries. Overall, the budget distribution in this center is almost in accordance with the international standards

Quality of Life among Persons with HIV/AIDS in Iran: Internal Reliability and Validity of an International Instrument and Associated Factors

The purpose of this cross-sectional study on 191 HIV/AIDS patient was to prepare the first Persian translation of complete WHOQOL-HIV instrument, evaluate its reliability and validity, and apply it to determine quality of life and its associated factors in Tehran, Iran. Student's t-test was used to compare quality of life between groups. Mean Cronbach's α of facets in all six domains of instrument were more than 0.6 indicating good reliability. Item/total corrected correlations coefficients had a lower limit of more than 0.5 in all facets except for association between energy and fatigue facet and physical domain. Compared to younger participants, patients older than 35 years had significantly lower scores in overall quality of life (P = 0.003), social relationships (P = 0.021), and spirituality/religion/personal beliefs (P = 0.024). Unemployed patients had significantly lower scores in overall quality of life (P = 0.01), level of independence (P = 0.004), and environment (P = 0.001) compared to employed participants. This study demonstrated that the standard, complete WHOQOL-HIV 120 instrument translated into Farsi and evaluated among Iranian participants provides a reliable and valid basis for future research on quality of life for HIV and other patients in Iran

Combined Physical Training Increases Plasma Brain-Derived Neurotropic Factor Levels, But Not Irisin in People Living with HIV/AIDS

International Journal of Exercise Science 14(3): 1004-1017, 2021. This study evaluated plasma levels of brain-derived neurotropic factor (BDNF), irisin, and lactate in people living with HIV/AIDS who completed a combined physical training program. Nineteen HIV+ participants (age: 39.60 ± 10.96 years; carrier time: 7.75 ± 7.88 years; time of ART: 6.41 ± 5.93 years) performed strength/aerobic training (combined physical training) in the same session for 8 weeks and levels of BDNF, irisin, and lactate were assessed. BDNF (pg/mL) was higher post-CPT (Pre: 1258.73 ± 372.30; Post: 1504.17 ± 322.30; p \u3c 0.001). Irisin (ng/mL) showed no change (Pre: 115.61 ± 72.41; Post: 125.87 ± 81.14; p = 0.973). There was positive correlation between irisin and lactate (mmol/L) pre (r = 0.55, p = 0.04), and lactate values were higher in the group with the highest value of irisin (3.65 ± 0.69 x 2.82 ± 0.59, p = 0.02). Combined physical training results in increased basal BDNF in people living with HIV/AIDS, this finding suggests that increased concentration of BDNF may be associated with decreased chances of developing cognitive disorders or HIV-associated dementia. Further studies involving molecular mechanisms on this subject are necessary

Comparison of adrenalectomy with conservative treatment on mild autonomous cortisol secretion: a systematic review and meta-analysis

ObjectiveThis systematic review and meta-analysis was conducted to compare the benefits of adrenalectomy and conservative treatment for comorbidities associated with mild autonomous cortisol secretion (MACS) in patients diagnosed with MACS.BackgroundMACS is the most common benign hormone-secreting functional adrenal incidentaloma. Overproduction of cortisol is observed in MACS patients, resulting in a variety of long-term health issues, including arterial hypertension (HTN), diabetes mellitus (DM), dyslipidemia, obesity, and osteoporosis; however, the classic clinical manifestations of Cushing’s syndrome (CS) are not present.MethodsA systematic search was conducted using MEDLINE, Embase, Web of Sciences, and Scopus databases on December, 2023. Two reviewers independently extracted data and assessed the quality of the included articles. A meta-analysis was performed to compare the beneficial effects of adrenalectomy versus conservative management for MACS-related comorbidities.ResultsFifteen articles were included in this study, which evaluated 933 MACS patients (384 Adrenalectomy and 501 Conservative treatment, and 48 excluded due to incomplete follow-up duration). MACS diagnosis criteria were different among the included articles. All studies, however, stated that there must be no overt CS symptoms. Meta-analysis demonstrates the overall advantage of adrenalectomy over conservative treatment for MACS-related comorbidities (Cohen’s d = -0.49, 95% CI [-0.64, -0.34], p = 0.00). Subgroup analysis indicated that the systolic blood pressure (pooled effect size = -0.81, 95% CI [-1.19, -0.42], p = 0.03), diastolic blood pressure (pooled effect size = -0.63, 95% CI [-1.05, -0.21], p = 0.01), and BMD (pooled effect size = -0.40, 95% CI [-0.73, -0.07], p = 0.02) were significantly in favor of adrenalectomy group rather than conservative treatment but no significant differences between the two treatment groups in other MACS-related comorbidities were reported.ConclusionDespite the limited and diverse data, this study demonstrates the advantage of adrenalectomy over conservative treatment for MACS-related comorbidities

Effect the pre-exposure prophylactic of hydroxychloroquine on severe COVID-19 disease: a randomized controlled trial

Background. In vitro studies have shown some effects for Hydroxychloroquine (HCQ) against SARS-CoV-2 virus. Despite effective vaccination program, relatively large proportion of population remains unvaccinated. So, there still remains a need for other prophylactic measures. The present study aims to evaluate whether HCQ can prevent severe COVID-19 outcomes among health-care workers. Materials and methods. In this randomized, double blind placebo-controlled clinical trial 334 healthcare workers aged 18–65 years old were included of whom 278 individuals completed the study. Participants were randomly assigned to the HCQ group (800 mg at day one, followed by 400 mg weekly for the next 7 weeks); or the placebo group. Participants were followed three weeks after the last dose of drug or placebo (10 weeks from the first dose of drug or placebo). The primary outcome was hospitalization or death from COVID-19. Results. Of 148 people who received HCQ, none were hospitalized or died from COIVD-19, while of 130 people who received the placebo, 2 (1.5%) were hospitalized for COIVD-19 (p-value: 0.26). And, 22 (14.9%) people in the HCQ group and 15 (11.6%) people in the placebo group contracted COVID-19 (p-value: 0.99). Adverse reactions were reported by 5 (3.4%) of participants in the HCQ group and 5 (3.9%) of participants in the placebo group (p-value: 0.99). Conclusion. We found that HCQ has no significant prevention effect on the incidence of mild COVID-19. However, the low rate of hospitalization (the primary outcome) in this trial like most of the other clinical trials with HCQ would have required increasing the sample size considerably to be able to comment on the effectiveness of HCQ in prevention of severe forms including death rate. This justifies systematic reviews to include similar studies to further investigate the issue

Monkeypox: a systematic review of epidemiology, pathogenesis, manifestations, and outcomes

Introduction. Since May 2022, an unusually large number of new monkeypox infections-a previously rare viral zoonotic disease, mainly reported from central and western Africa has been reported globally, and the World Health Organization (WHO) declared a global health emergency in July 2022. We aimed to systematically review the monkeypox virus epidemiology, pathogenesis, transmission, presentations, and outcomes. Materials and methods. Our aim is to systematically review the epidemiology, pathogenesis, manifestations, and outcomes of Monkeypox disease. We searched the keywords in the online databases of PubMed, Embase, Scopus, and Web of Science and investigated all English articles until December 2022. In order to ascertain the findings, this study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. In order to optimize the quality, this review study benefits from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To minimize any probable bias risk, we utilized the Newcastle-Ottawa Scale (NOS) risk assessment tool. Results. The most prevalent symptoms were rash and fever. The infection was accompanied by different complications such as, but not limited to, encephalitis (mainly in children), septicemia, bacterial cellulitis, retropharyngeal and parapharyngeal abscesses, etc. A wide range of hospitalization from 3.7% to 100% has been reported. The mortality rate ranged from 0% to 23%, which mainly occurred in infants and children. High mortality of the monkeypox rate was reported among pregnant women. The mortality rate of monkeypox is lower among women and those who received the smallpox vaccine compared to men and those who did not receive the vaccine. A wide range of the overall second-rate attack was reported, which is more pronounced in unvaccinated patients. Conclusion. In our systematic review of 35 studies on monkeypox, we cast light on the existing evidence on its epidemiology, pathogenesis, manifestation, and outcomes. Further studies are needed to elucidate the natural history of the disease in various patients’ population, as well as detailing the monkeypox attack rate