Mohammad Reza Sharif

Frequency of HBV, HCV and HIV infections among hospitalized injecting drug users in Kashan.

CONTEXT Infectious diseases including HIV and viral hepatitis constitute a major health issue, with high prevalence among injecting drug users (IDUs). AIMS The present study assessed the frequency of HIV, and hepatitis B and C viruses (HBV and HCV) among 200 IDUs, hospitalized between 2001 and 2006, in Shahid Beheshti Hospital of Kashan, Iran. SETTING AND DESIGN A population-based cross-sectional study in Iran. MATERIALS AND METHODS A total of 200 subjects participated in this study. Serological markers including HBsAg, anti-HCV antibodies and HIV were assessed by ELISA method using Monobid kits made in US. Demographic data was collected by using a questionnaire, which was designed by a researcher. STATISTICAL ANALYSIS USED Frequencies were determined by employing SPSS:PC version 15.0, and Chi-square and Fishers exact tests were used to compare proportions. RESULTS The mean age of subjects was 36.5 ± 10.2 years. Approximately 88.5% (177 cases) were male and 11.5%. (23 cases) were female. The frequency of positive infection test results for males with respect to HBV, HCV, and HIV was 4% (8 cases), 10.5% (21 cases), and 1.5% (3 cases); and for females it was 0.5% (1 case), 1.5% (3 cases), and 0% (0 case), respectively. CONCLUSION This study demonstrates that the frequency of HBV, HCV, and HIV infection in the IVD user in Kashan, Iran, is relatively high and this condition is more serious in male than female drug addicts. It is very important, especially for health providers and policy makers, to recognize the risk factors of HBV, HCV and particularly HIV infection in this area and design effective preventive programs.

Investigation of the effectiveness of Syzygium aromaticum, Lavandula angustifolia and Geranium robertianum essential oils in the treatment of acute external otitis: A comparative trial with ciprofloxacin

BACKGROUND Antibiotics and anti-inflammatory agents are the mainstay of acute external otitis (AEO) treatment. The present study investigated the effectiveness of a combination herbal drop (Lamigex) composed of essential oils from Syzygium aromaticum, Lavandula angustifolia, and Geranium robertianum in the alleviation of AEO symptoms and compared its effects to those of ciprofloxacin 0.3% drop. METHODS Seventy patients were randomly assigned to receive ciprofloxacin 0.3% (n = 35) or Lamigex (n = 35) drop. Each group was administered with three drops every 12 hours for a week. Patients were examined for AEO symptoms and ear discharge cultures at baseline as well as at the end of trial. Pain severity was also recorded using a visual analogue scale at baseline, the 3(rd) day, and the 7(th) day of the trial. RESULTS All assessed symptoms (tenderness, itching, erythema, edema and discharge) were equally improved in the ciprofloxacin and Lamigex groups by the end of trial (p > 0.05). There were remarkable reductions in the visual analogue scale score by the end of trial in both groups (p < 0.001). However, the rate of pain improvement was not found to be significantly different between the groups, either at the 3(rd) or 7(th) day of trial (p > 0.05). The numbers of positive cultures for all tested microorganisms were clearly reduced by the end of the trial in both groups but were not significantly different between the groups (p > 0.05). CONCLUSION The herbal combination drop that was investigated in the present study exhibited good efficacy in reducing the burden of infection as well as AEO symptoms.

Efficacy and Safety of Ferric Chloride in Controlling Hepatic Bleeding; An Animal Model Study

Background: Controlling parenchymal hemorrhage especially in liver parenchyma, despite all the progress in surgical science, is still one of the challenges surgeons face saving patients’ lives and there is a research challenge among researchers in this field to introduce a more effective method. Objectives: This study attempts to determine the haemostatic effect of ferric chloride and compare it with that of the standard method (suturing technique) in controlling bleeding from liver parenchymal tissue. Materials and Methods: In this animal model study 60 male Wistar rats were used. An incision, two centimeters (cm) long and half a cm deep, was made on each rat’s liver and the hemostasis time was measured once using ferric chloride with different concentrations (5%, 10%, 15%, 25% and 50%) and then using the control method (i.e. controlling bleeding by suturing). The liver tissue was examined for pathological changes. Results: The hemostasis time of ferric chloride concentration groups was significantly less than that of the control group (P value < 0.001). The pathologic examination showed the highest frequency of low grade inflammation based on the defined pathological grading. Conclusions: Ferric chloride is an effective haemostatic agent in controlling liver parenchymal tissue hemorrhage in an animal model.

Factors Influencing Animal Bites in Iran: A Descriptive Study

Objectives Animal bite is a significant health economic challenge worldwide. In Iran, there has been an increase in the number of animal bites in recent years. This study was performed to investigate the epidemiology of animal bites and their influencing factors in Semirom, Iran, from 2008 to 2012. Methods This was a descriptive study conducted for 5 years. The data were based on the information sheets presented in health-care centers concerning how to combat against rabies caused by animal bites. The data obtained were classified and analyzed statistically. Results During the 5-year study period, 1,246 animal bite cases were reported; 60% of the victims belonged to rural areas and the remaining 40% to urban areas. Among various aggressive animals, dogs had the highest rate of attacks (63.4%). The highest rate of animal bite (23.19%) was reported in the age group of 10–19 years and the lowest one (2.32%) was reported in the age group of 0–4 years. The animal bite rates among men and women were 76% and 24%; respectively. The highest and lowest rates were found among students (23.5%) and employees (5.5%), respectively. Regarding the commonly injured organ, the highest (67%) and lowest rates (23%) were for lower extremities and head and face, respectively. Regarding the nationality of the victims, 98% were Iranians and the rest were Afghan. Conclusion Given the increasing number of animal bites reported, there is a need to implement strategies to prevent bite-related complications, which may have health and financial burden on the country. It is also necessary to increase awareness among target groups and to formulate preventive strategies with the help of various authorities to control animal bites.

Fatigue and Vitamin D Status in Iranian Female Nurses

Introduction: Given that nurses are among professions with frequent problems of fatigue, and given the nature of their profession that provides little exposure to sunlight and the subsequent deficiency of vitamin D, the present study examined the relation between fatigue and circulating vitamin D levels in female nurses working in Shahid Beheshti Hospital, Kashan, Iran in 2013. Material and Methods: This cross-sectional study was conducted in 200 female nurses working in Shahid Beheshti Hospital. To measure fatigue, fatigue questionnaire containing 9 questions eliciting the subject’s feeling in scales of 1 to 7, getting a possible score of 9 to 63, and Visual Analogue Scale in which nurses specified their fatigue in a band of zero to 10 were used. The 25-hydroxyvitamin D, which is the most important vitamin D metabolite, also was determined. The data was analyzed by SPSS-16. The Pearson’s correlation of coefficients, t-test, and multiple regression analysis were used in this study. Results: The mean fatigue score of nurses was 38.76±12.66 in questionnaire and 5.73±2.12 in Visual Analog Scale. The 89 per cent of nurses suffered from vitamin D deficiency, 9.5 percent of them had normal level and 1.5 per cent had toxicity level of vitamin D. There was a significant relationship between vitamin D level and fatigue scores (P<0.0001), and visual fatigue scores (P<0.0001). According to multivariate regression analysis, vitamin D level accounted for 13 per cent of the fatigue based on data on questionnaire and 18.6 per cent of fatigue according to Visual Analog Scale. Conclusion: High prevalence of fatigue among nurses could be attributed to vitamin D deficiency.

Comparing the Effects of Two Feeding Methods on Metabolic Bone Disease in Newborns With Very Low Birth Weights

Introduction: Bone metabolic disease is an important issue in newborns with very low birth weight. The 80 percent of the transport of calcium (Ca) and phosphor (P) from mother to fetus takes place in the third trimester of pregnancy. This transport process is impaired with the preterm delivery of the newborn. On the other side, breast milk and formula are not competent resources to supply sufficient amounts of Ca and P to meet the requirements of the preterm newborn, thereby a greater reduction in the storage of these minerals. The current study has been done with the purpose of comparing the effects of two feeding methods on the indices of metabolic bone disease in newborns with very low birth weights (VLBW). Materials and Methods: The study design was cohort and the study was done on a total of 58 newborns with very low birth weights in Kashan Shahid Beheshti Hospital. The newborns were divided into two groups with 29 placed in the group of alternate feeding on preterm formula (preNan) and the other 29 placed in the group of breast milk and preterm formula (preNan). Eventually, the indices of bone metabolic disease were measured in both groups and were statistically analyzed. Results: The difference between the mean serum levels of Ca in different weeks and also between the two groups were significant (p=0.001). However, the changes in mean serum level of P in the two groups were not significant (P=0.151). The comparison of serum levels of alkaline phosphatase between the two groups indicated that their difference was significant and that they had been influenced by the feeding method (P=0.001). The serum level of bicarbonate, when compared between the two groups, was found to make a significant difference (P=0.001). The difference between the two feeding methods in precipitating rickets and osteopenia was not significant. Conclusion: According to the findings of current study, feeding on preterm formula (preNan) is associated with better and more desirable results, though the occurrence of rickets in the two groups had no significant difference.

Prevalence of BK viremia in Iranian hemodialysis and peritoneal dialysis patients.

Abstract Background: BK virus (BKV) is a common human polyomavirus which infects up to 90% of the general population with little clinical significance and with various epidemiological patterns of infection. Immune suppression is considered the main risk factor for BKV reactivation. Owing to their impaired cellular and humoral immunity, patients undergoing hemodialysis (HD) or peritoneal dialysis (PD) are at high risk of infectious diseases such as BKV infection. BKV presents with different distributions in different populations. This study aimed to determine the prevalence of BKV in Iranian patients with chronic renal disease undergoing HD and PD. Methods: Sixty-three HD patients and 33 PD cases from the main dialysis units in Tehran, Iran, were enrolled in the study. BK viremia was determined by qualitative polymerase chain reaction in all subjects. Results: Sixty-three cases under HD (mean age 59.3 ± 14.5 years) and 33 subjects on PD (mean age 53.7 ± 13 years) were enrolled in the study. The mean duration of HD was 59.1 ± 53.8 months and the dialysis interval was three times a week. In the PD group, the mean duration of dialysis was 38.9 ± 35.2 months. The prevalence of BK viremia was 3.03% in PD and 0% in HD subjects. Conclusions: This study showed a low rate of BK viremia in chronic renal disease patients undergoing HD or PD. Differently from other studies in various populations, our results demonstrated low or absent BKV replication in Iranian dialysis patients, highlighting the varying epidemiological pattern of BKV distribution.

The Relationship Between Iron Deficiency and Febrile Convulsion: A Case-Control Study

Introduction: Febrile seizure is among the most common convulsion disorders in children, which strikes 2% to 5% of children between 3 to 60 months of age. Some studies have reported that iron deficiency could be a risk factor for febrile seizure. The present study was conducted to compare the rate of iron deficiency anemia in febrile children with and without seizure. Materials and Methods: This case-control study evaluated 200 children aged 6-60 month in two 100 person groups (febrile seizure and febrile without convulsion) in Kashan. The CBC diff, serum iron and TIBC were done for all of participants. Diagnosis of iron deficiency anemia based on mentioned tests. Results: No significant differences were found in two groups regarding to the age, gender, and the disease causing the fever. The presence of iron deficiency anemia was 45% in the convulsion group and 22% in the group with fever without convulsion. The Chi Square test indicated a significant difference between two groups. Conclusions: The findings suggest that a considerable percentage of children having febrile seizure suffer from iron-deficiency anemia and low serum iron. This means the low serum iron and presence of anemia can serve as a reinforcing factor for the febrile seizure in children.

Association of the serum vascular endothelial growth factor levels with benign prostate hyperplasia and prostate malignancies.

Background: Recently, the development of new biomarkers as prognostic and predictive markers in prostate cancer has been crucial. Objectives: This study was aimed to determine whether serum vascular endothelial growth factor (VEGF) levels would be a prognostic marker or risk assessment factor in patients with prostate cancer and to investigate whether it could differentiate cancerous tissue from benign prostate hyperplasia (BPH). Patients and Methods: We enrolled 44 patients with prostate cancer, 57 patients with BPH, and 57 healthy individuals. Serum VEGF levels was measured by ELISA and was compared among all groups; then, its correlation with PSA and Gleason score in cancerous group was assessed. In addition, by using receiver operating characteristic (ROC) curve and area under curve (AUC), we determined the sensitivity and specificity of VEGF as well as combined variable of VEGF and PSA as a diagnostic marker of prostate cancer. Results: Serum VEGF level was significantly higher in patients with prostate cancer in comparison to the other groups (P value < 0.001); however, it was not different between BPH and control groups. Only in cancerous group a significant correlation between VEGF and PSA was found (r = 0.425, P = 0.004). Assessing the risk of prostate cancer, we found a powerful correlation between the VEGF alone as well as the combination of VEGF and PSA with prostate cancer. Conclusions: VEGF may be a diagnostic biomarker of prostate cancer. In addition, it may differentiate the cancerous tissue from BPH. We suggest that VEGF combined with PSA may be used as a screening test of prostate cancer.

The Effect of Ferric Chloride on Superficial Bleeding

Background: Controlling superficial bleeding, despite all the progress in surgical science, is still a challenge in some settings. Objectives: This study assesses the hemostatic effects of ferric chloride and compares it with the standard method (suturing technique) to control superficial bleeding. Materials and Methods: In this animal model study, 60 male Wistar rats were used. An incision, 2 cm long and 0.5 cm deep was made on rat skin and the hemostasis time was recorded using ferric chloride at different concentrations (5%, 10%, 15%, 25%, and 50%) and then using a control (i.e. control of bleeding by suturing). The skin tissue was examined for pathological changes. Finally, the obtained data were entered into SPSS (ver. 16) and analyzed using Kruskal-Wallis test, Mann-Whitney, Kolmogorov-Smirnov, and Wilcoxon signed ranks test. Results: The hemostasis time for the ferric chloride concentration group was significantly less than for the control group (P < 0.001). Conclusions: Ferric chloride may be an effective hemostatic agent to control superficial bleeding in rats.