The study of feasibility and acceptability of using HIV self-tests in high-risk Iranian populations (FSWs, MSM, and TGs): a cross-sectional study

Background

This study aimed to evaluate the feasibility of using the HIV self-test in high-risk Iranian groups (MSM, FSWs, and TGs).

Methods

This study was a mixed study designed as a quantitative–qualitative study conducted between October 1, 2020, and June 22, 2021, in Tehran and Karaj, Iran. The sample size needed for this study generally was 1000 people, including FSWs, MSM, and transgender individuals. Convenience and snowball sampling methods were used to collect the samples.

Results

A total of 930 eligible respondents were enrolled in the study, of whom 456 (49%) were female and 49 (5.3%) were transgender (98% of TGs were male to female), and their mean age was 33.63 years (10.54 SD). The feasibility of using HIV self-tests in Iranian high-risk groups was significantly high. The majority of participants (97%) did not have any confidentiality problems while preparing or performing the test. In general, feasibility was assessed based on five questions. The overall feasibility score was 6.33 (0.824 SD). Taking tests, reading HIV test results, finding a safe place to do the test, and accessing HIV self-tests showed a high average.

Conclusion

HIV self-testing was highly acceptable and feasible among high-risk populations, so routine HIV testing was efficiently possible.

Induced abortion and associated factors among female sex workers in Iran

OBJECTIVES

Induced abortion is an occupational hazard for female sex workers (FSWs). This study aimed to examine the prevalence and factors associated with induced abortion among FSWs in Iran.

METHODS

1337 FSWs aged ≥18 years who reported selling sex to more than one male client in the past 12 months were recruited in 13 major cities in Iran between January and August 2015. Bivariable and multivariable modified Poisson regression models were constructed to examine the correlates of induced abortion. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were reported.

RESULTS

Lifetime induced abortion was reported by 621 of 1335 participants (46.5%; 95% CI 43.8, 49.2). Older age (APR for ≥ 35 vs. < 25 years, 1.46; 95% CI: 1.03, 2.07), having ever been married (APR 1.58; 95% CI 1.05, 2.39), having ever worked in a brothel (APR 1.19; 95% CI 1.02, 1.38) and a lifetime history of being raped (APR 1.19; 95% CI 1.03, 1.38) were significantly associated with lifetime induced abortion (all p < 0.05).

CONCLUSION

The high prevalence of induced abortion among FSWs in Iran is concerning. Evidence-informed programmes targeting FSWs in Iran would improve their knowledge and encourage contraceptive use as well as promote pregnancy prevention and post-abortion care.

[Semen analysis in involuntary childlessness. What information does it provide?]

Involuntary childlessness is a common problem. In about 50% of cases, inadequate semen quality plays a relevant role. A semen analysis provides information regarding exocrine function of the male reproductive organs of the testes, epidydimis, seminal vesicles, prostate gland, and vas deferens. These parameters can only be interpreted in conjunction with medical history and physical examination. Then they can be useful to identify relevant disorders or the causes of these disturbances. The fundamental principles for the interpretation of a semen analysis are easily learned and traditionally belong to the field of dermatology. This article explains the variables which are examined in a routine semen analysis as well as the reference values. Furthermore, common causes for deviations from the normal values are discussed to allow decision-making for further diagnostic workup. The interpretation of these values must always take into account the situation of the couple.

Effectiveness and efficacy of minimally invasive lung volume reduction surgery for emphysema

Lung emphysema is a chronic, progressive and irreversible destruction of the lung tissue. Besides non-medical therapies and the well established medical treatment there are surgical and minimally invasive methods for lung volume reduction (LVR) to treat severe emphysema.

This report deals with the effectiveness and cost-effectiveness of minimally invasive methods compared to other treatments for LVR in patients with lung emphysema. Furthermore, legal and ethical aspects are discussed.

No clear benefit of minimally invasive methods compared to surgical methods can be demonstrated based on the identified and included evidence. In order to assess the different methods for LVR regarding their relative effectiveness and safety in patients with lung emphysema direct comparative studies are necessary.

The Comparative Evaluation of the Performance of Two Phytoremediation Systems for Domestic Wastewater Treatment

The constructed wetlands as well engineered techniques have been used effectively for phytoremediation of wastewater and pollution control during the last decades. In these technologies, the naturally occurring processes of plants alongside micro-organisms present in the bio-film attached to the roots, soil substrate and water column degrade the organic pollutants. The study seeks to compare the potential use of Phragmites sp. reed bed and floating macrophyte water hyacinth (Eichhornia crassipes) system for domestic wastewater treatment. The sewage treatment performance is evaluated as 80% & 76% chemical oxygen demand (COD), 90% & 87% biological oxygen demand (BOD5), 24% & 18% total dissolved solids (TDS), 69% & 67% total suspended solids (TSS), 12% & 5% Chlorides, 73% & 69% ammonia nitrogen (NH3-N), 42% & 31% phosphate (PO4-P), 93% & 91% most probable number (MPN) and 95% & 92% total viable count (TVC) reduction at optimum hydraulic retention time (HRT) of 24 & 43 h in Phragmites sp. and water hyacinth systems, respectively. Likewise, the floating macrophyte pond contrary to reed bed process shows insignificant pollutant diminution at 24 h HRT. This paper also highlights the microbial population present through the wetland systems by estimation of total viable count (TVC). The botanical aspect with reference to the plant growth is shown a significant increase in vegetation yield. The overall studies indicate the better treatment efficiency by preferred Phragmites sp. root zone system at low foot print area for domestic wastewater.

The role of the nose in obstructive sleep apnea: a short review

A variety of causes may result in nasal obstruction including allergic and non-allergic rhinitis, anatomic abnormalities, and postoperative nasal packing. There is both an epidemiological and clinical relationship between nasal obstruction and sleep disordered breathing. Subsequently, improving nasal patency via surgical or non-surgical means is expected to relieve sleep disordered breathing. The present review will discuss and review some of the literature related to the pathophysiological interaction of the human nose and sleep disordered breathing and provide a summary of the effects of related intervention trials.

Synthesis of Cu/CuO nanoparticles in mesoporous material by solid state reaction

The Mobil Composition of Matter No. 41 (MCM-41) containing 1.0 and 5.0 wt.% of Cu was synthesized under solid state reaction. The calcinations of samples were done at two different temperatures, 500 and 300°C. X-ray diffraction (XRD), UV-Vis diffuse reflectance spectroscopy (UV-Vis DRS), Fourier transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM) were used for samples characterization. Powder X-ray diffraction showed that when Cu(CH3COO)2 content is about 1.0 wt.% in Cu/MCM-41, the guest CuO-NPs and copper ions is formed on the silica channel wall, and more exists in the crystalline state. When Cu(CH3COO)2 content exceeds this value (5.0 wt.%), CuO nanoparticles and Cu(2+) ions can be observed in low crystalline state. From the diffuse reflectance spectra it was confirmed that 5 wt.% Cu/MCM-41 sample calcined at 500°C show plasmon resonance band due to Cu nanoparticles in the range between 500 and 600 nm and small copper clusters Cun in 450 nm. It also shows that some of the Cu(2+) ions are present octahedrally in extraframework position in all samples. Both fourier transform infrared and diffuse reflectance spectra indicate that some of Cu(2+) ions are tetrahedrally within the framework position in 1 wt.% Cu/MCM-41 samples. TEM images indicated that nanoparticles size of CuO is in range of 30-40 nm.

Endobronchial valve-induced pneumatocele: a case report

We report a 75-year old female patient with advanced emphysema. After endoscopic lung volume reduction with endobronchial valves (EBV), a huge pneumatocele has occured and resolved spontaneously within a few weeks. Albeit rare, pneumatoceles should be considered in patients with relapsing dyspnoe after EBV treatment.

A case of tracheobronchial amyloidosis treated with endoscopic debulking and external beam radiation therapy

We report on a 55-year-old patient who was admitted to hospital because of recurrent pneumonia. CT imaging provided airway narrowing and mural thickening of the distal trachea and mainstem bronchi, compatible with endobronchial polypoid, toric-shaped changes of the distal tracheal wall spreading into both the left and right bronchial system. Bronchoscopy was performed and biopsies revealed the diagnosis of tracheobronchial amyloidosis. We performed a combination of bronchoscopic debulking and consecutive external beam radiation therapy with the result of no further progression of the disease, stable endobronchial situation, and functional improvements at a follow up at 6 months.

Comparative evaluation on the performance of bio-rack and shallow pond systems for domestic wastewater treatment

Constructed wetlands have been used successfully for treatment of wastewater during the last decades. The bio-rack and shallow pond systems are well engineered wetland process in wastewater treatment. The aim of this study is to compare the potential use of bio-rack and shallow pond systems for domestic wastewater treatment either in presence of high total dissolved solids (TDS) or heavy metal salts. The sewage treatment performance indicates 75.15% & 80.93% chemical oxygen demand (COD), 86.59% & 90.90% biological oxygen demand (BOD5), 27.54% & 15.98% total dissolved solids (TDS), 73.13% & 70.31% total suspended solids (TSS), 8.86% & 3.61% Chlorides, 70.22% & 74.18% ammonia nitrogen (NH3-N), 31.71% & 41.24% phosphate (PO4-P), 92.11% & 96.45% most probable number (MPN) and 93.05% & 98.24% total viable count (TVC) reduction at 10 & 21 h hydraulic retention time (HRT) in bio-rack and shallow pond system respectively. Likewise, the Phragmites sp. and water hyacinth can tolerate TDS up to 9000 and 2000 mg/L. The reduction in TDS is minor (14 & 19%) at the highest tolerable limit whereas the heavy metal reduction is 68 & 65%, 69 & 67%, 67 & 63%, 71 & 69% for Cd, Cu, Ni and Zn in bio-rack and shallow pond system respectively. The overall studies indicate the better treatment efficiency in bio-rack system at low foot print area (91 m2) compared to shallow pond system.

[A leak in the lung: endobronchial one-way valve placement as treatment for a persistent bronchopleural fistula]

Patients with bronchopleural fistula are at an increased risk of morbidity and mortality. Treatment of the air leak includes intrathoracic drainage, antibiotic therapy and closure of the fistula, which conventionally has been performed via surgical means. In patients with limited respiratory capacity, less-invasive alternatives are required. Here we report on a 62-year-old patient with underlying severe COPD, who was admitted with a lung abscess and consecutively developed a persistent bronchopleural fistula. Treatment involved antibiotic therapy and endobronchial one-way valve placement, which resulted in termination of the air leak and full recovery.

Non-CPAP therapies in obstructive sleep apnoea

In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS. This report summarises the efficacy of alternative treatment options in OSAS. An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine. Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients.

Some factors affecting cerebral tissue saturation during obstructive sleep apnoea

Measurement of cerebral tissue saturation during obstructive sleep apnoea (OSA) may provide additional information to conventional peripheral oxygen saturation. Thirteen subjects with OSA (mean apnoea/hypopnoea index 65.7+/-27.9) were monitored using full polysomnography and monitoring of near-infrared cerebral tissue oxygenation index (TOI). One-thousand and thirty-six apnoeas and hypopnoeas were analysed, in terms of duration, sleep stage, arterial oxygen saturation (Sa,O2) dip, minimum Sa,O2, TOI dip and minimum TOI. Cerebral TOI is a measure of cerebral tissue saturation of haemoglobin with oxygen, calculated using near-infrared spatially resolved spectroscopy, which has been shown to have a high specificity for intracranial changes. Decreases in cerebral oxygenation were observed during apnoeas and hypopnoeas. Baseline TOI ranged from 50.1-73.0% and mean apnoea/hypopnoea related TOI dips ranged from 1.43-6.85%. Mean Sa,O2 dips varied from 3.8-21.7%. In regression analysis, factors significantly predicting the magnitude of the TOI dip were Sa,O2 dip, minimum Sa,O2, apnoea duration and rapid eye movement sleep stage. The effect of apnoea duration and sleep stage remained significant after Sa,O2 was included in the regression equation. Near-infrared spectroscopy provides a noninvasive technique for monitoring cerebral tissue saturation during obstructive sleep apnoea.