HIV Prevalence and Related Behaviors Among People Who Inject Drugs in Iran from 2010 to 2020

AIDS and Behavior - Injection drug use has been the leading route of HIV transmission in Iran. We assessed HIV prevalence, risk behaviors, and uptake of prevention services among people who inject...     

Macular amyloidosis: an assessment of prevalence, sex, and age

Macular amyloidosis is a relatively common cutaneous disease in Asia and the Middle East. It is characterized by a reticulated or rippled pattern of pigmentation mostly in the upper back. This study was performed not only to determine the disease sex and age distribution, but also to evaluate its risk factors and the frequency among the dermatology clinic patients. Based on the clinical and random histopathologic findings, 100 macular amyloidosis patients were evaluated in a period of 3 years. Although the sex distribution (9 : 1, female : male ratio) differed dramatically from most of the previous reports, it was consistent with few other series. Eighty one percent of patients were between 21 and 50 years of age. The mean age of the female patients was higher than that of the males (difference of two means was 10.26 years and P = 0.027). Backscatching during bathing probably is not a common practice in Iran, therefore we could not consider this as a risk factor in our study. We found no evidence of any other associated risk factors.     

N-methylhydroxylamine inhibits and M&B 22948 potentiates relaxations of the mouse anococcygeus to non-adrenergic, non-cholinergic field stimulation and to nitrovasodilator drugs.

1. The effects of N-methylhydroxylamine (NMH) and of M&B 22948 on relaxations of the mouse anococcygeus to non-adrenergic, non-cholinergic (NANC) field stimulation and to a number of smooth muscle relaxant drugs were investigated. 2. Relaxations to NANC field stimulation (10 Hz; 60 s train) were reversibly blocked by NMH (1-5 mM), which also caused weak, transient reductions of carbachol (50 microM)-induced tone. N,N-dimethylhydroxylamine (2 mM) and hydroxylamine (5 microM) reduced tone to the same extent as NMH, but neither produced any inhibition of NANC relaxations. 3. M&B 22948 10 microM, which by itself reduced tone by 12%, potentiated submaximal but not maximal relaxations to NANC field stimulation; overall the log frequency-response curve was displaced to the left by a factor of 2. 4. Sodium nitroprusside (0.01-1 microM), hydroxylamine (0.5-100 microM), and nitric oxide (2-200 microM) all relaxed carbachol-induced tone; relaxations to submaximal concentrations of these nitrovasodilators were reduced in the presence of 2 mM NMH, and potentiated in the presence of 10 microM M&B 22948. 5. Neither NMH (2 mM) nor M&B 22948 (10 microM) affected relaxations induced by submaximal concentrations of vasoactive intestinal peptide (VIP; 1 microM), papaverine (10 microM), 3-isobutyl-1-methyl-xanthine (10 microM), or 8-bromo-cyclic guanosine monophosphate (100 microM); relaxations to adenosine 5'-triphosphate (ATP, 2 mM) were unaffected by M&B 22948, but were potentiated by NMH.(ABSTRACT TRUNCATED AT 250 WORDS)     

Penile Sclerosing Lipogranulomas and Disfigurement from Use of “1Super Extenze” among Laotian Immigrants

IntroductionSubcutaneous penile injection of various oils for penile augmentation has been described among men in Laos. We have now treated three Laotian immigrants with penile disfigurement secondary to sclerosing lipogranulomas, also known as paraffinoma, induced by injection of a mineral oil compound marketed as “1Super Extenze,” which they purchased in the United States.AimThis series describes the clinical course and management of complications associated with the use of “1Super Extenze” in three Laotian men.MethodsSurgeons excised all grossly affected tissue and performed reconstruction using skin grafting, Z‐plasty, and tissue advancement, respectively. Tissue from the penile shaft of each patient and a local lymph node in one patient was examined microscopically. Mass spectroscopy was performed on an aliquot of “1Super Extenze.”Main Outcome MeasuresUrinary function, sexual function, and cosmesis of the three reported cases, chemical composition of “1Super Extenze,” and microscopic analysis of penile and regional lymphatic tissue.ResultsShort‐term cosmetic and functional outcomes were acceptable after surgical intervention. Histologic findings consistent with sclerosing lipogranulomas were seen in specimens from affected subcutaneous and lymphatic tissue. “1Super Extenze” proved to be composed of mineral oil with tocopherol acetate (vitamin E).ConclusionInjection of “1Super Extenze” into the penile shaft results in sclerosing lipogranulomas, which can cause severe sexual and urinary complications. Surgical resection of all grossly involved tissue with appropriate reconstruction can mitigate these problems. This series supports previous recommendations in the literature that men should avoid the use of non‐medical foreign bodies and fillers as means of penile augmentation. Manny T, Pettus J, Hemal A, Marks M, and Mirzazadeh M. Penile sclerosing lipogranulomas and disfigurement from use of “1Super Extenze” among Laotian immigrants. J Sex Med **;**:**–**.     

Acute generalized exanthematous pustulosis due to thallium

Acute generalized exanthematous pustulosis (AGEP) is characterized clinically by fever, pruritus and acute pustular eruption. Usually a drug is found to be the responsible agent. We present a patient who experienced an acute generalized exanthematous pustulosis due to radioactive thallium. The eruption cleared rapidly after discontinuation of the drug and systemic corticosteroid therapy.     

Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah,Iran: A Latent Class Analysis

The objective of this study was to explore patterns of drug use and sexual risk behaviors among people who inject drugs (PWID) in Iran. We surveyed 500 PWID in Kermanshah concerning demographic characteristics, sexual risk behaviors, and drug-related risk behaviors in the month prior to study. We used latent class analysis (LCA) to establish a baseline model of risk pro?les and to identify the optimal number of latent classes, and we used ordinal regression to identify factors associated with class membership. Three classes of multiple HIV risk were identified. The probability of membership in the high-risk class was 0.33, compared to 0.26 and 0.40 for the low- and moderate-risk classes, respectively. Compared to members in the lowest-risk class (reference group), the highest-risk class members had higher odds of being homeless (OR = 4.5, CI: 1.44–8.22; p = 0.001) in the past 12 months. Members of the high-risk class had lower odds of regularly visiting a needle and syringe exchange program as compared to the lowest-risk class members (AOR = 0.42, CI: 0.2–0.81; p = 0.01). Findings show the sexual and drug-related HIV risk clusters among PWID in Iran, and emphasize the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug use related.     

Cyclic nucleotide content of the rat anococcygeus during relaxations induced by drugs or by non-adrenergic, non-cholinergic field stimulation.

Low concentrations of sodium nitroprusside (0.2 and 1 microM) relaxed carbachol-induced tone of the rat anococcygeus but did not affect the content of either cGMP or cAMP; higher concentrations (10,100 and 1000 microM) produced greater relaxation (greater than 60%) and a rise in cGMP but not cAMP. In the presence of the cGMP-phosphodiesterase inhibitor M&B 22948 (10 microM), 1 microM sodium nitroprusside produced greater relaxation and a selective increase in cGMP. Forskolin (0.5-250 microM) caused relaxation and a selective increase in cAMP; the concentration-response relationships of the two effects were similar. Non-adrenergic, non-cholinergic (NANC) field stimulation (10 Hz; 20 s trains) reduced tone by 52% but had no effect on cyclic nucleotide content; in the presence of 10 microM M&B 22948 or 1 microM sodium nitroprusside, NANC stimulation produced a greater degree of relaxation and increased cGMP but not cAMP content. The results show that NANC stimulation acts like sodium nitroprusside, causing a selective increase in cGMP, and this supports the proposal that NANC transmission in the rat anococcygeus involves an endogenous nitrate; the possibility that multiple pools of cGMP exist in the anococcygeus is discussed.     

Comparing Characteristics of Early-Onset Injection Drug Users to Those With Late-Onset Injection in Kermanshah,Iran

Background: Characteristics and behaviors of early-onset injection drug users are under studied topics in Iran. This study aimed to identify and compare the demographic characteristics as well as the drug using behaviors of early-onset and late-onset injection drug users in Kermanshah, West Iran. Methods: In this cross-sectional study using snowball and convenience sampling, we recruited 450 people during the Fall of 2014 from two drop in centers in Kermanshah, Iran. We collected data through face-to-face interviews. Early-onset injection is defined as whether the person reported their first injection at 22 years of age or younger. Subsequently, late-onset injection is defined as 23 years of age or older. We compared the characteristics of the two groups through both univariate and multiple logistic analyses. Results: Overall, 54% (CI 95%: 44.3%, 62.2%) were early injectors. After controlling for low socioeconomic status, initiation of drug use at a young age, multiple drug use and methamphetamine use were all significantly associated with a higher likelihood of early-onset injection. Additionally, early-onset injection was associated with recent syringe borrowing (OR = 2.6, p = 0.001), recent syringe lending (OR = 1.4, p = 0.01), recent cooker sharing (OR = 3.2, p = 0.01) and injecting two or more times a day (OR = 2.2, p = 0.04). Conclusion: Early-onset injectors were more likely to report a lower socioeconomic status, initiation of first drug use at a younger age, using methamphetamine alongside polydrug use, and engaging in higher risk taking behaviors like borrowing needles. With these associations, the study emphasizes the need for drug-prevention programs to focus on the transition to injection drug use at younger ages.