Prevalence of HIV infection and associated risk behaviors among people who inject drugs in Kermanshah, Iran: 2017

Background: Globally, the prevalence of HIV infection among People Who Inject Drugs (PWIDs) is higher than the general population due to high-risk behaviors. The aim of this study was to determine the prevalence of HIV infection and associated risk behaviors among male PWIDs in Kermanshah city in 2017. Methods: We surveyed 606 male PWIDs in Kermanshah city. Data on demographic characteristics and risk behaviors associated with HIV infection were gathered through structured interviews. HIV was also measured through venous blood testing. Eligible participants were recruited from two drop-in centers using snowball sampling. Simple and multiple logistic regression was used to investigate the risk behaviors of HIV infection. Results: Among 606 male PWIDs in this study, prevalence of HIV infection was 6.40% (95% CI: 1.61–4.32). Older age (Adjusted Odds Ratio; AOR = 1.08, 95% CI: 1.02–1.15) and older age at first drug injection (Adjusted Odds Ratio; AOR = 0.91, 95% CI: 0.85–0.97) were risk factors for HIV infection. Conclusion: This study implies that prevalence of HIV among male PWIDs is higher than the general population. Older age and older age at first drug injection were risk factors for HIV infectio

Intestinal Parasites Infection in Children with Cancer in Ahvaz, Southwest Iran

Background. Infection with intestinal parasites is widespread worldwide, especially in developing countries. Intestinal parasites are known as one of the leading causes of diarrhea in both immunocompetent and immunocompromised subjects, but cancer patients are highly susceptible to contamination, and it can be deadly for them. This study aimed to estimate the prevalence of intestinal parasites in immunocompromised patients in Ahvaz. Material and Methods. In this descriptive cross-sectional pilot case-control study, fecal samples were collected from 52 children with malignancies hospitalized in Baqaei2 hospital in Ahvaz. A questionnaire including demographic information, type of cancer, type of gastrointestinal symptoms, and laboratory diagnosis was completed for each patient. The collected specimens were examined by direct smear, Logul staining, and concentration. Result. The 52 stool samples were collected, 46% were female and 54% male. The age range of children enrolled in the study was from 4 months to 16 years. Of these stool samples, 38.38% were infected with a variety of parasitic intestinal infections (helminths and protozoa). In this study, protozoan parasites, Blastocystis (23%), Chilomastix mesnili (1.92%), Endolimax nana (7.7%), and Entamoeba coli (1.92%), and helminth infection, Strongyloides stercoralis (3.84%), were observed and statistical analysis showed that there was a significant relationship between gastrointestinal symptoms and parasitic infection in children with cancer. Conclusion. Blastocystis and Endolimax nana are the most prevalent gastrointestinal parasitic protozoans that infect individuals admitted to Baqaei2 Hospital of Ahvaz, Iran. Since parasitic intestinal infections in immunocompromised patients lead to fatal diarrhea, children with parasitic infections must be carefully identified and treated

Effect of nature-based sound therapy on stress and physiological parameters in patients with myocardial infarction

Background: Non-pharmacological interventions in clinical practice, such as Nature-Based Sounds (N-BS), can be an efficient way to reduce stress in patients with Myocardial Infarction (MI). This study was an attempt to investigate the effect of N-BS on stress and physiological parameters in patients with MI. Materials and Methods: This double-blind, randomized clinical trial was conducted on 80 patients with MI from two selected hospitals. Using headphones, the subjects in the intervention group listened to 30 minutes of N-BS twice a day for 3 days. The control group, on the other hand, wore headphones playing no sound. The data were collected using the Persian version of the Depression, Anxiety, and Stress Scale. The significance level was set at 0.05. Results: The repeated measure analysis showed that the within group effect is statistically significant for Systolic Blood Pressure (SBP) (F = 113.32, P < 0.001), Diastolic Blood Pressure (DBP) (F = 67.22, P < 0.001), Heart Rate (HR) (F = 28.52, P < 0.001), respiration rate (F = 36.41, P < 0.001), and stress (F = 102.82, P < 0.001). The reciprocal effect was statistically significant for SBP (F = 11.76, P < 0.001) and stress (F = 5.31, P < 0.001). Conclusions: N-BS can provide an effective, inexpensive, and non-invasive method of reducing stress in patients with MI. Nurses can incorporate N-BS intervention into the daily care of patients with MI in order to reduce their stress and lower their SBP and HR

Estimation of direct and indirect effects of risk behaviors on HCV infection among people who inject drugs in Kermanshah, Iran: a path analysis study

Background: Hepatitis C virus (HCV) infection is global health problem with an estimated 415,000 deaths in 2015. The objective of this study was to explore the direct and indirect effects of risk behaviors on HCV infection among male PWIDs (people who inject drugs) in Kermanshah, Iran. Methods: We surveyed 606 male PWIDs in Kermanshah city. Data on demographic characteristics and risk behaviors associated with HCV infection were gathered through structured interviews. The participants were recruited from two drop-in centers using snowball sampling. We used path analysis to explore the direct and indirect effects of risk behaviors on HCV infection among male PWIDs. Results: Over half of the 606 participants had been exposed to HCV with 54.80% having a positive test for HCV antibodies. Older Age of first of drug injection [B Coefficient: ?0.03, 95% confidence interval (CI): ?0.04, ?0.01] and regular attendance at harm-reduction programs (B Coefficient: ?0.21, 95% CI: ?0.43, ?.01) reduce the chance of HCV exposure. Longer duration of injection (B Coefficient: 0.09, 95% CI: 0.06, 0.12) was associated with higher probability of HCV exposure. Conclusion: This study implies that age of first of drug injection, regular attendance at harm-reduction programs and duration of injection had both direct and indirect effects on HCV infection. Keywords:HCV; risk factors; drug injection; path analysi

Age–sex differences in the global burden of lower respiratory infections and risk factors, 1990–2019: results from the Global Burden of Disease Study 2019

Summary Background The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities