fahimeh hadavand

Colistin, a last-resort antibiotic, faces a growing threat from antibiotic resistance. This study aims to comprehensively assess colistin resistance in clinical isolates of Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae in Iran.

Relevant studies on the prevalence of colistin resistance among multidrug-resistant Gram-negative bacteria in Iran, published up to December 15, 2023, were identified through searches of databases such as PubMed/Medline, EMBASE, and Scopus. The overall frequency of colistin resistance for each bacterial species was determined using CMA version 3.

The comprehensive analysis of clinical isolates revealed varying frequencies of colistin resistance among the studied Gram-negative bacteria. E. coli displayed a resistance rate of 3.6%, while P. aeruginosa exhibited a rate of 6.5%. A. baumannii demonstrated a resistance rate of 4.7%, and K. pneumoniae displayed the highest resistance rate at 7.2%. Importantly, the analysis found no significant evidence of publication bias, enhancing the reliability of these resistance rate estimates.

Colistin resistance among these clinically significant Gram-negative bacteria in Iran is rising, limiting treatment options and posing serious challenges to healthcare providers. These findings underscore the urgency of enhanced surveillance, the development of alternative treatments, and the implementation of strict infection control measures. Addressing colistin resistance is crucial to effectively managing infections caused by these pathogens in Iran and globally.

Providencia species are opportunistic pathogens that can rarely cause nosocomial infections. They possess numerous virulence characteristics, such as intrinsic antibiotic resistance, which enable them to cause lethal outbreaks. The emergence of pan-drug resistant (PDR) isolates amplifies the threat of Providencia spp. to human health.

We described an outbreak caused by PDR Providencia spp. in the intensive care unit (ICU) of our medical center.

This outbreak occurred at Imam Hossein Hospital in Tehran, Iran, between 20 June and 28 July 2023. The majority of the 14 patients experienced ventilator-associated pneumonia (VAP); however, two others had surgical site infections (SSI) and peritoneal abscesses. Samples were subcultured on Blood agar, Chocolate agar, and MacConkey agar, as well as differential gallery mediums. Additionally, susceptibility to antimicrobial agents was determined by the disk diffusion protocol using Mueller-Hinton (MH) agar.

The rapid diagnosis of the outbreak and practical measures recommended by the infection prevention and control (IPC) committee (e.g., sampling from other patients, hands of healthcare workers, and the environment to identify further cases and the source of the infection, contact isolation, disinfection of the ICU with 1% chlorine solution, and combined antibiotic therapy) assisted us in managing it. Nevertheless, the outbreak resulted in the mortality of eight patients, despite these preventive and therapeutic measures.

Clinicians should be aware of nosocomial infections caused by opportunistic pathogens such as Providencia spp., especially in ICU-admitted patients with prolonged hospitalizations and broad-spectrum antibiotic administration. Strong clinical suspicion and timely detection of outbreaks, investigation of further cases, contact isolation of infected patients, disinfection of the environment, treatment with combined antibiotic regimens, and re-sampling of patients and the environment are the cornerstones of managing outbreaks caused by Providencia spp.

According to the increasing trend of antibiotic consumption all over the world, a rising concern is the emergence of resistant pathogens due to the inappropriate use of antibiotics, which increases the risk of treatment failure and mortality. Antibiotic Order Form (AOF) is an antimicrobial stewardship program protocol recommended to improve rational antibiotic use. We aimed to compare the antibiotic consumption rate, i.e., vancomycin and carbapenems, before and after preprinted AOFs were implemented. This study also evaluated physicians' compliance with AOFs as a secondary outcome. This prospective descriptive study was conducted from July to December 2015 in a 570-bed teaching hospital in Tehran, Iran. AOF includes demographics, microbiological, and clinical data on infection designed for vancomycin and carbapenems, including imipenem and meropenem. Prescribers were asked to fill out predesigned forms after prescribing the selected antibiotics and deliver them to the pharmacy on July 1, 2015. Collected data during this 6-month study period were compared with the same period times years 2011 to 2016 (4 years before and one year after implementation of AOF) to determine the effect of AOFs on the selected antibiotics consumption that had been calculated based on Daily Doses per 100-patients day (DDD/100-bed days). This study showed that although vancomycin had an increasing trend from 2011 to 2014, implementing the AOF program could stop this trend in 2015. vancomycin consumption significantly decreased compared to the previous year (P = 0.039). This effect of the program was not the same on the use rate of carbapenems, and their use was increased nonsignificantly in 2015 (P = 0.606). The acceptance of prescribers in filling out the forms for vancomycin increased from 5.12% in the first month to 57.75% in December. This increase was from 4.20% to 37.26% for carbapenems. According to the increasing trend of antibiotic consumption in hospitals, we recommend improving utilization surveillance of antibiotics by choosing an appropriate antibiotic, optimal dosing, and desired duration of treatment that are important in decreasing the risk of developing resistant microorganisms due to misuse. The forms are much more effective when accompanied by the acceptance of prescribers.

Nonspecific clinical features and imaging findings of COVID-19 may lead to misdiagnosis with other diseases that have specific risks and treatments. Here a patient is reported with Pneumocystis Pneumonia with an undiagnosed HIV disease who was treated for COVID-19 with no response after one week. COVID-19 was diagnosed by CT findings but PCR was negative. Further evaluation for ground glass opacities confirmed AIDS and clinical response to Pneumocystis Pneumonia treatment.

Since the emergence of coronavirus disease 2019 (COVID-19), many people have been vaccinated worldwide. Despite the preventive role of vaccines, their side effects face disease management with challenges. This study aims to investigate the side effects of COVID-19 vaccination among healthcare workers in Tehran, Iran.

This cross-sectional study was conducted from April to October 2022 on 377 healthcare workers in Tehran, Iran. Data collection was carried out through an interview by a researcher using a checklist assessing systemic and local side effects of COVID-19 vaccines.

The mean age of participants was 36.03±10.24 years, and 68.2% were female. Participants experienced significantly more local (26.5% vs. 14.3%, P<0.001) and systemic (52.0% vs. 31.8%, P<0.001) side effects after the first dose than after the second dose. After the first dose, AstraZeneca (45.9%) caused significantly more local reactions than Sputnik V (21.7%) and Sinopharm (14.5%). AstraZeneca (83.7%) caused significantly more systemic side effects than Sputnik V (50.7%) and Sinopharm (14.5%). The prevalence of local and systemic side effects after the first dose was significantly different in terms of vaccine types (P<0.001). After the second dose, AstraZeneca (20.4%) caused significantly more local reactions than Sputnik V (12.8%) and Sinopharm (10.5%) (P<0.001). Additionally, AstraZeneca (38.8%) and Sputnik V (37.4%) caused significantly more systemic side effects than Sinopharm (7.9%) (P<0.001).

Most healthcare workers in Tehran experienced flu-like symptoms and local reactions at the injection site after vaccination against COVID-19, mainly after the first dose. They had more side effects after vaccination with AstraZeneca and Sputnik V, compared to Sinopharm.

Since the coronavirus disease 2019 (COVID-19) pandemic began, several vaccines have been manufactured to subside it. This study aimed to determine the prevalence of side effects after injecting common COVID-19 vaccines available in Iran.

This cross-sectional study was accomplished on Shahid Beheshti University of Medical Sciences (Tehran, Iran) employees during January and September 2022. Eligible participants were selected based on the simple ran- dom method and interviewed about side effects after injecting COVID-19 vaccine.

The mean age of 656 participants was 38.03 ± 9.53 years, and 453 (69.1%) were female. The prevalence of post-vac- cination side effects was higher after receiving the first dose (53.2%) than the second (35.9%) and third (49.4%) doses. Across all three vaccine doses, the overall proportion of side effects was higher following AstraZeneca than the others. The most common side effect after the first dose of the vaccine was myalgia (41.9%), followed by fever (36.6%), chills (31.6%), local reactions (27.0%), headache (25.5%), and sweating (21.6%). People experienced mainly myalgia (23.3%) and fever (20.3%) after injecting the second dose of the vaccine. Additionally, the participants had myalgia (37.2%), fever (30.8%), chills (29.2%), local reactions (26.0%), and headache (24.4%) after the third dose of the vaccine.

AstraZeneca had a higher proportion of post-vaccination adverse effects than Sputnik V, Pastocovac, and Sin- opharm. The most common side effects were flu-like syndrome and local reactions at the injection site. Furthermore, people rarely experienced life-threatening side effects. Thus, the available COVID-19 vaccines in Iran are safe.

 Invasive fungal infections are among the most important causes of death in patients with neutropenic fever. Early detection of the cause of neutropenia and appropriate treatment, including experimental antifungal therapy, plays a key role in reducing mortality and cutting financial costs for the individual and society.

 In this retrospective study, the records of 33 patients with fever and neutropenia who received antifungal drugs (including Amphotericin B, Voriconazole, Caspofungin, and Fluconazole) were evaluated. Neutropenia was defined as episodes of fever (axillary temperature > 38.2°C or oral temperature > 37.7°C) and neutrophil count < 500 /μL persistent for five days despite antibacterial therapy without an infectious etiology. For statistical analysis, SPSS software version 21 was used.

 In this study, out of 33 neutropenic patients receiving antifungal therapy, a fungal agent was defined in 19 patients (59%). Mucor species was the most common cause of fungal infections, followed by aspergillus and candida. Liposomal Amphotericin B and Caspofungin were the most common antifungal agents used for treating patients with neutropenic fever. Antifungal therapy in neutropenic patients resulted in 50% recovery and 50% mortality. Statistical analysis showed that neutropenic patients did not have a significant difference in response to treatments based on age groups and gender.

 The study highlights the importance of experimental therapy in neutropenic patients based on clinical criteria and risk factors, and with a diagnostic approach, rather than general treatment.

Acute cholecystitis needs to be treated due to its high prevalence and mortality rate worldwide and high consumption of antibiotics before and after surgery for this disease.

This study investigated the microbiology of bile samples and their antibiogram in patients with acute cholecystitis referred to the Imam Hossein Hospital, Tehran, Iran, in 2019 - 2020.

This cross-sectional study was performed on 97 patients with acute cholecystitis. A surgeon collected bile samples before cholecystectomy. Then, the samples were examined for culture and antibiogram. The results were analyzed using SPSS 16 statistical software.

Among the measured variables, only the relationship between the age category and culture result was statistically significant (P < 0.032). Also, the culture result was negative in 67% of the patients, and in the positive culture of the samples, organisms grown mainly were Escherichia coli, Pseudomonas, and Enterococcus. Among the organisms, 53.1% were susceptible, and in resistant cases, the most resistant mechanism was extended-spectrum beta-lactamase (ESBL). Moreover, the relationship between different organisms with the sex of patients (P < 0.032) and having gallstones (P < 0.011) was significant.

According to studies, 30 - 50% of cholecystitis cultures of bile samples were positive, the most common organisms growing in these cultures include Ecoli, Pseudomonas, Klebsiella pneumonia, and Enterococcus and Salmonella species. Also, the most common mechanisms of antibiotic resistance are ESBL, CRE, and AmpC types, respectively. More research needs to be carried out on the prevalence of microbes in cholecystitis and other diseases and the selection of appropriate antibiotic regimens and mechanisms of antibiotic resistance.

Brucellosis is one of the most prevalent zoonoses, with an annual incidence of half a million cases globally. Most parts of Iran are endemic for Brucellosis. Given the worse prognosis, knowledge and early diagnosis of the complicated forms is especially important. The present study aimed to identify the clinical and paraclinical predictive alarms for complications in Brucellosis.Materialsand

This study was done as a retrospective study on records of inpatients suffering active Brucellosis in Imam Hussein Medical Center, SBMU, Tehran in 15 years (2001April-2016 March) as the census. Epidemiological, clinical, and laboratory data were collected in the formerlyprepared questionnaire. According to their clinical and paraclinical findings, cases were studied in two groups: Complicated and Uncomplicated. All data were analyzed and compared using SPSS version 19.0 ANOVA and K2tests (P values <0.05).

In 95 patients suffering Brucellosis, 56 (59%) were male, and 39 (41%) were female. 69 (73%) cases were evaluated as uncomplicated, and 26 (28%) cases were as complicated. 11(28%) of females and 20 (35%) male cases were complicated without significant statistical difference. Arthritis was the most common form, followed by the nervous system. The mean patient age was 35.4622.2 years, (ranging 1-86) with no difference in two groups and different complications. The frequency of the previous history of Brucellosis and unpasteurized dairy product use was more common in complicated cases but was not significant. Myalgia (92% vs. 50%) and fever (50% vs. 9%) were significantly more common in complicated Brucellosis. Lab test results had no significant mathematical difference.

Myalgia and fever were significantly more common in complicated Brucellosis. There was no significant difference in other classical symptoms of Brucellosis as sweating, malaise, fatigue, and chills between the two groups and no significant difference in serologic tests titer and lab tests.

Critically ill patients are at risk for development of stress-related mucosal damage (SRMD). Proton Pump Inhibiros (PPIs) like pantoprazole are extensively used to prevent SRMD in ICU settings. It is not known with certainty that either oral or intravenous pantoprazole is associated with a better response. Our goal was to compare effects of intravenous pantoprazole with oral pantoprazole on gastric pH in children admitted to PICU. In this blinded trial, 80 patients were randomly divided into two groups. Patients in in the first group received oral pantoprazole (1 mg/kg/day/divided) and patients in the second received IV pantoprazole (1 mg/kg/day/divided). The gastric pH was measured 48 hours after pantoprazole administration using litmus paper. The mean age was 990 days. After 48 hours, the gastric pH was 4.46 ± 1.48 in patients received pantoprazole orally and it was 4.85 ± 1.52 in patients received pantoprazole intravenously. There was no significant difference between two study groups (P= 0.252).  Besides, no significant differences were noted in rate of diarrhea and nosocomial pneumonia between 2 study groups (P > 0.05). This study showed that both intravenous and oral pantoprazole had similar effects on gastric acid of children hospitalized in PICU. It seems reasonable to use oral pantoprazole to reduce the costs of treatment.

Diabetic nephropathy (DN) is a major complication of diabetes Mellitus. Early detection and intervention of DN can slow its progression and improve patients’ outcomes. Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of tubular damage might become a useful biomarker for the evaluation of renal involvement in diabetic patients. We aimed to evaluate the serum and urine NGAL(s-NGAL and u-NGAL) in type 2 diabetic patients and its correlation with different stages of diabetic nephropathy.

This cross-sectional study was designed on 198 subjects consisted of 50 controls and 148 type 2 diabetes patients (50 normoalbuminuric, 58 microalbuminuric, and 40 macroalbuminuric). The study was conducted with measuring s-NGAL and u-NGAL, albumin and spot urine creatinine were also measured.

A highly increased level of s-NGAL was detected in macroalbuminuric group compared with controls, normoalbuminurics and microalbuminurics (P < .01). Highly raised u-NGAL levels were observed in macroalbuminurics in comparison with controls (P < .01). ROC curve demonstrated the best sensitivity and specificity of s-NGAL/u-NGAL for the macroalbuminuric state (sensitivity, 26% and 60%; specificity, 98% and 72%; respectively), in which the best cut-off points for the detection of macroalbuminuric state for s-NGAL/u-NGAL were 300 ng/mL and 71.4 ng/mL, respectively.

Serum and urine-NGAL are elevated in type 2 diabetic patients, with or without albuminuria, s-NGAL level clearly correlates with severity of renal damage caused by DN and u-NGAL increases in macroalbuminuric state. S-NGAL could be a useful, noninvasive, available and practical test for evaluation of diabetic renal involvement. We could suggest u-NGAL as a probable predictor of macroalbuminuria.

One of the most important steps in diagnosis and treatment of diseases is taking a good medical history. Current medical history form of Ministry of Health and Medical Education in our country doesn’t have Review of System part. In this research quantity and quality of Interns’ recording ROS in a new form including this part was studied. This is a Quasi-experimental study. In control group current medical history form without ROS part and in the cases group new proposed form including ROS part were used to take medical history by interns. Quantity and quality of ROS writing were evaluated by Infectious Disease residents and specialists. All data were compared by K2 and Fisher T test in SPSS 24 software. In control group, 2% of interns had written ROS, all in incorrect place, with moderate quantity. In case group, ROS was written 100% in correct place, with quality of low, moderate, good, very good as 3%, 8%, 71% and 18% in order of frequency. Infectious disease residents’ and specialists’ satisfaction quality as low, moderate, good, very good were 8%, 14%, 72%, 6% and 7%, 15%, 71%, 7% in order with significant difference. (p <0.001) In conclusion we found significant relation between quality and quantity of recording data with using medical history form with ROS part by interns. It is proposed to change current form to a new one with ROS part.

 Vitamin D insufficiency is common in critically ill patients. It is hypothesized that vitamin D deficiency would be associated with sepsis in the critically ill. Thus, the present study aimed to investigate the association between vitamin D and sepsis severity.

 In this cross-sectional study, patients with sepsis referring to a university hospital in Tehran, Iran, from February 2018 to March 2019 were included. Plasma concentrations of vitamin D in critically ill subjects admitted were assessed. Data were analyzed using SPSS version 20.0. P-values less than 0.05 were considered statistically significant.

 Among the investigated patients, the mean serum level of vitamin D3 was 19.03 ± 13.08 ng/mL. The prevalence of vitamin D insufficiency in critically ill subjects with sepsis was 100% (150/150). Only sex (P = 0.01) indicated a significant association with vitamin D. Patients suffering from severe sepsis had lower levels of vitamin D compared to the patients with non-severe sepsis (P = 0.07).

 The present study showed that all critically ill patients studied had vitamin D insufficiency. In line with the biological evidence, the present study suggests that vitamin D deficiency may predispose patients to sepsis. Further studies are needed to establish the causes and mechanisms underlying these interpretations.

 Identification of the causes of gallstone would result in better planning for the prevention of this disease. One of the proposed risk factors for this problem is Helicobacter pylori(H. pylori) infection.

 The purpose of this study was to determine the incidence rate of gallstone in patients with H. pylori gastritis.

 This was an observational study performed as a descriptive-comparative cross-sectional survey. We enrolled 169 consecutive patients with H. pylori gastritis admitted to Imam-Hossein Hospital, Tehran, Iran, in 2018, and gallstone frequency in them was determined and compared with other variables.

 Overall, 14 (8.3%) patients had gallstone, and all the patients had H. pylori gastritis. There was no significant association between gallstone and H. pylori gastritis (P = 0.561).

 It may be concluded that gallstone frequency in patients with H. pylori gastritis is low, and there is no significant association between these two conditions.

Streptococcus pneumoniae commonly asymptomatically colonizes the human upper respiratory tract and the carriage rate varies between geographical regions. The colonized individuals are not only at risk of infections but also can be a source of transmission of the pathogen. The risk of the droplet or airborne transmission of pneumococcal strains healthcare workers is considerable. The current study aimed to determine the extent of nasopharyngeal colonization with S. pneumoniae and their levofloxacin susceptibility at a tertiary hospital in Tehran, Iran.

During a six-month period, the nasopharyngeal swab samples collected from 300 volunteer healthcare workers of Imam Hossein Hospital. Samples screened for S. pneumoniae using standard conventional biochemical methods. The minimum inhibitory concentration (MIC) of levofloxacin was determined using a commercially available strip antibiotic test according to the clinical laboratory standards institute (CLSI) guidelines.

A total of 19 (6.3%) enrolled healthcare workers were colonized with S. pneumoniae. Amongst the enrolled volunteers, nurses had a higher rate of pneumococcal colonization (47.3%) followed by interns (21%) and laboratory workers (15.8%). Our analysis revealed that there was a significant correlation between smoking and pneumococcal colonization. The antimicrobial susceptibility testing showed that all of the isolates were susceptible to levofloxacin (MIC≤2 μg/ml).

This low rate of pneumococcal colonization amongst healthcare professionals may be attributed to the low risk of horizontal transmission of severe pneumococcal infections in the hospital. Additionally, our findings indicated that levofloxacin was an effective antimicrobial agent for the treatment of pneumococcal infections.

Bacterial resistance is a worldwide phenomenon that can disrupt the treatment of many different infectious diseases. Identifying drug-resistant bacteria is very important in different aspects, such as choosing the appropriate antibiotics, accelerating treatment, reducing the costs of treatment, and preventing antibiotic resistance.

Therefore, the present study was aimed to investigate the prevalence of drug-resistant Gram-negative bacteria in a teaching hospital in Tehran, Iran.

In the present cross-sectional study, all clinical specimens that were obtained from patients admitted to the Imam Hossein Hospital for infections caused by Gram-negative bacteria during 2017 were included. The pattern of antibiotic resistance was determined by the disk diffusion test as recommended by the Clinical Laboratory and Standards Institute (CLSI) guideline.

The result of the culture for 295 patients under study was reported as positive for Gram-negative bacteria. The most frequent Gram-negative bacteria were Escherichia coli (31.2%), followed by Klebsiella spp (20.3%) and Pseudomonas spp (13.2). The most antibiotic resistance was observed against cephalexin, ceftriaxone, and cefotaxime.

Resistance in Gram-negative bacteria was relatively high in the current study. Establishment of better infection control policies and education of hospital staff, especially in the ICU are recommended for the prevention and control of drug-resistant pathogens in the health care settings.

Human immunodeficiency virus (HIV) is one of the major infectious agents, which has important role in the public health challenges, which have affected the world's economic and social situation recent decades. During the last decades, millions of people died due to HIV infection worldwide. However, data remain limited on the causes of death among HIV-infected in Iranian population. The aim of the present study was to assess the cause specific death among HIV positive inpatient persons in Iran.

This surveillance was conducted on inpatient HIV positive admissions at Masih Daneshvari Hospital, Tehran, Iran during October 2016 and April 2017.All patient’s data were collected via abstraction form, which were ascertained, from medical records and from written logbooks that were kept by the nursing staff on the ward. The data of each admission was recorded from the medical reports at the time of admission and upon discharge. All laboratory data were collected and recorded separately.

Fifty persons were diagnosed as HIV-infected patients, of which 58% of them were classified as AIDS patients. Our findings indicated that the cause of hospitalization were pulmonary 54%, neurological 20%, gastrointestinal 16%, and dermal 10% complications. Overall, 21 patients (42%) were diagnosed with pulmonary tuberculosis, of which one patient died from tuberculosis complications. Four patients died during the study period.

In conclusion, early treatment and/or early use of ART can be improved outcomes. Therefore, early HIV testing and early ART use play important role in mortality reduction among eligible persons.

Considering the importance of early diagnosis of diabetic foot ulcers and its complications, this study aimed to evaluate the accuracy of erythrocyte sedimentation rate (ESR), C - reactive protein (CRP), and pro-calcitonin (PCT) in predicting the ulcer class, osteomyelitis, and peripheral arterial disease (PAD). This cross-sectional study was performed on 200 consecutive patients suffering from diabetic foot ulcer who were referred to Infectious Disease Ward. The levels of PCT, ESR, and CRP were measured for all patients and the screening performance characteristics of each marker in predicting the ulcer class, osteomyelitis, and PAD was calculated. The levels of PCT, ESR and CRP were significantly higher in patients with class IV foot ulcer compared to those with class III ulcers (p<0.001). Patients with evidence of osteomyelitis had significantly higher level of PCT, ESR and CRP. The best cutoff points of PCT, ESR and CRP in predicting osteomyelitis were 0.35 ng/ml (86.1% sensitivity, 45.3% specificity), 56.5 mm/hours (95.8% sensitivity, and 50.0% specificity) and 44 mg/ml (90.3% sensitivity, 57.0% specificity), respectively. The presence of PAD was significantly associated with increased levels of the three biomarkers. The best cutoff values for PCT, ESR and CRP in predicting PAD were 0.45 (70.8% sensitivity, 71.7% specificity), 61.5 (83.3% sensitivity, 52.0% specificity) and 49 (83.3% sensitivity, 63.8% specificity), respectively. Based on the findings of the present study, although the accuracy of PCT, ESR, and CRP in predicting the severity of diabetic foot ulcers was fair, increase in the three parameters can predict the occurrence of osteomyelitis and PAD following diabetic food development with good accuracy and acceptable sensitivity.

Helicobacter pylori (H.pylori) infection may contribute to the development of extra-gastrointestinal manifestations like cardiovascular diseases. Detection of Helicobacter pylori in Athrosclerotic plaques is a strong evidence for this association which may play a role in pathogenesis of atherosclerosis with classic cardiovascular risk factor such as hypertension and lipid profile. The aim of this study was to explore the influence of H. pylori infection on lipid profiles in a large community- based study. A total of 1754 (50.8% Female & 49.2% male) subjects (age >25 years old) were selected randomely from Monica Healthy Heart Study project. H. pylori status was determined by IgG ELISA method. Subjects with titers > 30 Iu/ml were cansidered seropositive. Data were analazed by using statistical software Spss version 18 and probability values <0.05 were considered statistically significant. In multiple logistic regression analyses H.pylori infection did not show significant association with Lipid profiles (low HDL- cholesterol and High LDL- cholesterol) after controlling for age, sex, body mass index, hypertension, type 2 diabetes mellitus, smoking and circulating hsCRP levels.(P>0.05) According to this large – scale population- based study in large northern cities of Persian Gulf, there was no significant association between H.pylori IgG seropositivity and lipid profiles in both men and women.

Given the longevity achievable with current prophylactic and therapeutic strategies for persons with HIV infection, quality of life (QOL) has emerged as a significant medical outcome measure, and its enhancement has an important goal. This review highlights the relevance and complexity of physical, psychological, and social factors as determinants of health-related quality of life in HIV-infected person in Bushehr province.

This cross-sectional study was conducted using a convenience sampling method on 54 patients living with HIV or suffering from AIDS on 2009. The method of data collection was summarized questionnaire of World Health Organization (WHO-QOL-Brief). The main measured outcome in this study was quality of life and some related demographic and clinical variables.

The majority of the patients were males (46/54) and unemployed (37).25 participants were married. The mean±SD age of the patients was 38.1+ _7.47 years. Employment, marital status, level of education, and clinical stage of the disease, had a significant effect on the quality of life of the patients. In multivariate analysis, the most important predictor of the quality of life was job.

The most important factors, association with decreased quality of life of the Patients in this study, were being separated or divorced, unemployment and being at severe stage of the disease. The relationship of these measures to treatment outcomes can and should be examined in clinical settings in resource-limited countries.