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

Impact of Social Media on Psychological Health: Challenges and Opportunities

Background and Aim: During the past few years, social networking has become very popular. Currently, there is a lack of information about the uses, benefits, and limitations of social media for health communication in society.Material and Methods: This paper will review some of challenges and opportunities to use social and their impact on psychological health. In this review we searched all valuable and relevant information considering the social media impact on psychological health. We referred to the information databases of Medline, PubMed, Scopus and Google scholar.Conclusion: Social media brings a new dimension to health care, offering a platform used by the public, patients, and health professionals to communicate about health issues with the possibility of potentially improving health outcomes. More study is required to establish whether social media has impact on mental health in both the short and long terms

Impact of an Antimicrobial Stewardship Program on the Frequency of Drug resistant Bacteria in an Intensive Care Unit

Background: One of the major health problems in the intensive care unit (ICU) is the nosocomial infection caused by multidrug-resistant (MDR) pathogens. The antimicrobial stewardship program (ASP) is a solution to prevent antibiotic resistance. This study aimed to determine the impact of an antimicrobial stewardship program on the frequency of drug-resistant bacteria in an ICU.Materials and Methods: This quasi-experimental study was conducted between 2019 and 2021 in Labbafinejad Hospital, Tehran, Iran. This study consisted of two time periods: 1) one year with no restriction of antibiotic prescription (before ASP), and 2) one year with restriction of antibiotic prescription based on the stewardship program (after ASP). We obtained demographic and clinical characteristics of patients from their medical records. Standard disk diffusion and broth microdilution were used to determine the antibiotic susceptibility of bacterial pathogens isolated from the patients.Results: A total of 300 ICU-admitted patients were included in the study (150 for each period). We found out that the total length of hospitalization, length of hospitalization in ICU, and treatment duration were lower after ASP (P=0.022, P=0.383, and P<0.001, respectively). Also, the frequency of antibiotic resistance, including MDR and Vancomycin-Resistant Enterococci (VRE) strains, decreased significantly after performing ASP (P=0.013). However, in terms of mortality, there was no significant difference between the two periods (P=0.236).Conclusion: The results of our study highlight the implementation of the antibiotic Stewardship program and the rational use of antibiotics in the ICU setting to inhibit the spread of antibiotic-resistant bacteria

Impact of an Antimicrobial Stewardship Program on the Frequency of Drug resistant Bacteria in an Intensive Care Unit

Background: One of the major health problems in the intensive care unit (ICU) is the nosocomial infection caused by multidrug-resistant (MDR) pathogens. The antimicrobial stewardship program (ASP) is a solution to prevent antibiotic resistance. This study aimed to determine the impact of an antimicrobial stewardship program on the frequency of drug-resistant bacteria in an ICU. Materials and Methods: This quasi-experimental study was conducted between 2019 and 2021 in Labbafinejad Hospital, Tehran, Iran. This study consisted of two time periods: 1) one year with no restriction of antibiotic prescription (before ASP), and 2) one year with restriction of antibiotic prescription based on the stewardship program (after ASP). We obtained demographic and clinical characteristics of patients from their medical records. Standard disk diffusion and broth microdilution were used to determine the antibiotic susceptibility of bacterial pathogens isolated from the patients. Results: A total of 300 ICU-admitted patients were included in the study (150 for each period). We found out that the total length of hospitalization, length of hospitalization in ICU, and treatment duration were lower after ASP (P=0.022, P=0.383, and P<0.001, respectively). Also, the frequency of antibiotic resistance, including MDR and Vancomycin-Resistant Enterococci (VRE) strains, decreased significantly after performing ASP (P=0.013). However, in terms of mortality, there was no significant difference between the two periods (P=0.236). Conclusion: The results of our study highlight the implementation of the antibiotic Stewardship program and the rational use of antibiotics in the ICU setting to inhibit the spread of antibiotic-resistant bacteria

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

Candidemia in Febrile Neutropenic Patients; a Brief Report

Introduction: Febrile neutropenic patients are at risk of serious infections. The aim of the present study is to identify the frequency, species, and susceptibility patterns of candidemia in febrile neutropenic patients. Methods: This cross-sectional study was conducted on febrile neutropenic patients suspected with candidemia who had been referred to 3 educational hospitals during 9 months. Results: The blood samples of 80 febrile neutropenic patients with the mean age of 48§16.6 years were studied (60% female). Five (6.25%) episodes of candidemia were identified. The underlying disease was acute myeloid leukemia in 4 (80%) cases and all 5(100%) cases had central venous catheter and were receiving prophylactic ciprofloxacin and acyclovir. 100% of isolates were found to be susceptible to Voriconazole, 80% to Caspofungin, 60% to Amphotericin B, and 40% to Fluconazole. Conclusion: The frequency of candidemia among the studied febrile neutropenia patients was 6.25%, with 80% mortality rate, and themost frequently identified yeastwas Candida albicans (100% susceptible to Voriconazole)

Effects of adding convalescent plasma therapy for treatment of COVID-19 patients with severe and critical symptoms: a descriptive study of 12 cases

Background: Severe symptoms of COVID-19 could be actually life-threatening and fatal. No effective treatmenthas been proposed yet. Plasma from COVID19 recovered patients may be effective according to past similarstudies of some other viral infections.Materials and Methods: This study was conducted at the infectious disease ward of Shahid Labbafi NejadHospital (Tehran, Iran) from 3rd of April 2020 up until 3rd of May 2020. Clinical information for the 12 patients,before and after receiving convalescent plasma transfusion was obtained from a review of the hospital computermedical system retrospectively and analyzed.Results: Out of 12 patients with Covid-19 who received convalescent plasma, 7 patients were male (58.3%)and 5 were female (41.7%). The mean age of the patients was 52 years. Among them, 50% (n=6), improvedand discharged and the rest of them died. Mean O2 saturation of patients with final outcome of death anddischarged before plasma therapy were 67 (33%) and 77 (83%), respectively, an improvement, defining partialresolution of lesions of chest CT scan or stop in progression of infiltrations was detected in all of 6 dischargedpatients.Conclusion: Convalescent plasma may have effective role in improving O2 saturation, lymphopenia and CT scanlesions and also decreasing inflammatory factors of cases with severe manifestations but could not changeprognosis for critically ill patients. Therefore, an early administration of convalescent plasma may be helpful

Antibiotic Resistance and RAPD-PCR Genotyping of Pseudomonas aeruginosa Clinical Strains Isolated from Intensive Care Unit Patients

Background: Pseudomonas aeruginosa is one the most important nosocomial pathogens, especially in immunocompromised patients. Identifying the source of contamination in health centers plays an important role in the control of hospital infections. The aim of this study was to determine antibiotic susceptibility and genetic patterns of P. aeruginosa isolated from patients hospitalized in intensive care unit of Masih Daneshvari Hospital, Tehran, Iran. Materials and Methods: Antibiotic susceptibility of the isolates was examined through 10 antibiotics recommended by Clinical and Laboratory Standards Institute (CLSI, 2018) guidelines using the Kirby-Bauer disc diffusion method. Random amplified polymorphic DNA (RAPD) analysis with the short primer of 272 was used to evaluate genetic relationship among the isolates and the results were analyzed by Gelcompar II software. Results: Of the antibiotics used, the most sensitive was found in colistin (96.4%) and the highest resistance rates were observed in cefotaxime (94.6%), chloramphenicol (83.9%) and imipenem (71.4%). DNA fingerprinting was able to identify 12 genetic patterns by RAPD-PCR technique. Conclusion: Antibiotic resistance in isolates of P. aeruginosa is rising and there is possibility of occurring outbreaks in the medical centers. Different sources of strains show their constant exchange via intra- and extra-hospital transmission routes. Thus, according to the data of this study, there is a serious need to control sources of infections by physicians and staff when they are working in several sectors to control and prevent the transmission of the bacterium

Prevalence of Epstein–Barr virus, Human Papillomavirus and Porphyromonas Gingivalis in Oral Cancer

Background: Multiple risk factors are supposed to progress oral cavity carcinoma and among them, the role ofneither bacterial nor viral infections should be underestimated. Despite relentless efforts, the accelerating effectsof human papillomavirus (HPV), Epstein–Barr virus (EBV), and Porphyromonas gingivalis (P. gingivalis) onoral cancer has not yet been recognized successfully. Taking advantage of these facts, in this study we evaluatedthe prevalence of HPV, EBV, and P. gingivalis in oral cavity carcinoma.Materials and Methods: A total of 43 oral cavity cancerous tissues and 29 healthy oral ones were collected fromLoghman Hospital, Tehran, Iran, between 2016 and 2018. After DNA extraction, the prevalence of HPV, EBV,and P. gingivalis was evaluated by PCR.Results: There were 53.5 well-differentiated (15 male, 9 female), 41.8% moderate (10 male, 5 female), and4.7% poor (1 male, 3 female) adenocarcinoma paraffin-embedded tissue samples. PCR analysis has shownthat there were 1 HPV (age: 46; moderate adenocarcinoma) and 1 EBV (age: 62; moderate adenocarcinoma)positive in different samples. No P. gingivalis was found and there was not any infected tissue with both EBVand HPV. In 31% of control tissues, blisters were observed and in 51.7% there was no mucus. We did not findany association between age, sex, and HPV, EBV positive samples.Conclusion: As sample size can affect the results of epidemiological and clinical study, and due to the lownumber of positive samples in this study, we concluded that HPV, EBV, and P. gingivalis may not have adetrimental effect on the progression of oral cancer, but further studies are needed

Gastrointestinal Tuberculosis with Cecum Involvement in a 33-Year-Old Woman

Abdominal tuberculosis is one of the most prevalent forms ofextra-pulmonary tuberculosis. Various regions of gastrointestinaltract including cecum, terminal ileum, peritoneum, lymphaticsystem, and solid viscera can be affected by tuberculosis.Here we report a 33-year-old woman presented with fever,chills, and a history of abdominal discomfort. Lymphadenopathywas detected on physical examination. Contrast computedtomography of chest and abdomen showed patchy densitiesand thickening of the ileocecal wall respectively. Histologicalstudies of the biopsy samples documented the existence oftuberculosis