Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

Objective:To identify the frequency of syphilis among Iranian HIV-positive patients.Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital,Tehran,Iran.The lab tests including CD4 cell count,cerebrospinal fluid,veneral disease research laboratory(VDRL),fluorescent treponema antibody-absorption(FTA-Abs)and viral load were performed for all the patients.Data regarding medical history and their demographics were also collected.Results:Of all 450 HIV-positive patients,24(5.3%)had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45%of them had a definite co-infection of syphilis.65.3%of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%.We did not find any patient with neurosyphilis.Conclusions:Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations,the diagnosis of syphilis should be timely established using screening tests among such patients.

Prevalence of HIV infection and the correlates among homeless in Tehran,Iran

Objective:To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran,Iran.Methods:In 2007-2008,Tehran municipality stacked up 10657 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS(IRCHA)departments to conduct HIV infection prevalence surveys in homeless populations.The results were analyzed for associations with demographic information,family support,status of drug abuse and relation with family and friends.Results:Overall HIV prevalence was 1.7%(95%confidence interval 1.4-1.9).Factors independently associated with HIV infection included history of using drugs[AOR 8.15(4.86-13.67)].older age[AOR1.80(1.08-2.99)for 40-55 yr],occupation[AOR 1.64(1.19-2.24)for unemployed],and no relation with family[AOR 1.82(l.30-2.54)|.Conclusions:This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless.Harm reduction programs should be expanded,particularly among homeless injection drug users.

Evaluating clinical abdominal scoring system in predicting the necessity of laparotomy in blunt abdominal trauma

Objectives： Trauma is among the leading causes of death. Medical management of blunt abdominal trauma （BAT） relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients＇ signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system （CASS）, a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods： Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale （GCS）, pulse rate, time of presentation after trauma, abdomial clinical findings, respiratory rate, temperature, hemoglobin （Hb） concentration, focused abdominal sonography in trauma （FAST） and CASS. Results： Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy （P〈0.05）. Conclusion： CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.

The relationship between illnesses and medical drug consumption with the occurrence of traffic accidents among truck and bus drivers in Tehran,Iran

Purpose: To determine the relationship of illnesses and medical drug consumption with the occurrence of traffic accidents among truck and bus drivers. Methods: This is a cross-sectional study on truck and bus drivers in Tehran, Iran. The criteria for participating in this study were: married males over 30 years old, driving license in grade one, five years of job experience, mental health and non-addiction license. The criterion for not participating in this study was the lack of cooperation in responding to the questions. Six months was spent to collect the latest five years data of driving accidents from 2011 to 2016. A total of 323 truck and bus drivers in Tehran city and the suburbs, Iran were chosen. Among them, 112 were responsible for accidents (accident group) while 211 were not responsible for any accidents or involved in an accident in the last five years (nonaccident group). A specially designed questionnaire was used to investigate the demographic information, medical drug consumption, medical backgrounds and history of accidents. Results: The results revealed that compared with healthy subjects, the occurrence of accidents among people with diabetes (OR = 2.3, p = 0.001) and vision weakness (OR = 1.7, p = 0.020) was significantly higher, while that among people with cardiac (OR = 0.5, p = 0.002) and hypertension (OR = 0.9, p = 0.048) problems was remarkably lower. Moreover, consumption of Gemfibrozil (OR = 1.8, p = 0.010) and Glibenclamide (OR = 2.2, p = 0.002) drugs resulted in significantly higher incidence of accidents than those without. Conclusion: Frequencies of illnesses like cardiovascular and hypertension were not higher in accident drivers than in non-accident drivers;but diabetes, vision weakness and consumption of Gemfibrozil and Glibenclamide lead to more traffic accidents.

Alcohol consumption for simulated driving performance： A systematic review

Purpose： Alcohol consumption can lead to risky driving and increase the frequency of traffic accidents, injuries and mortalities. The main purpose of our study was to compare simulated driving performance between two groups of drivers, one consumed alcohol and the other not consumed, using a systematic review. Methods： In this systematic review, electronic resources and databases including Medline via Ovid SP, EMBASE via Ovid SP, PsyclNFO via Ovid 5P, PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature （CINHAL） via EBSCOhost were comprehensively and systematically searched. The randomized controlled clinical trials that compared simulated driving performance between two groups of drivers, one consumed alcohol and the other not consumed, were included. Lane position standard deviation （LPSD）, mean of lane position deviation （MLPD）, speed, mean of speed deviation （MSD）, standard deviation of speed deviation （SDSD）, number of accidents （NA） and line crossing （LC） were considered as the main parameters evaluating outcomes. After title and abstract screening, the articles were enrolled for data extraction and they were evaluated for risk of biases. Results： Thirteen papers were included in our qualitative synthesis. All included papers were classified as high risk of biases. Alcohol consumption mostly deteriorated the following performance outcomes in descending order： SDSD, LPSD, speed, MLPD, LC and NA. Our systematic review had troublesome heterogeneity. Conclusion： Alcohol consumption may decrease simulated driving performance in alcohol consumed people compared with non-alcohol consumed people via changes in SDSD, LPSD, speed, MLPD, LC and NA. More well-designed randomized controlled clinical trials are recommended.