Association of the efficiency of hemodialysis instruments in the removal of microbial and chemical pollutant.

Dialysis water is vital because of various harmful contaminants for patients. The aim of this study was to assess the efficiency of hemodialysis instruments in the removal of microbial and chemical pollutant in educational hospitals affiliated to Ahvaz Jundishapur University of medical sciences, Iran during 2018-2019. This cross-sectional descriptive research studied the microbial and chemical water quality of hemodialysis instruments in Razi, Sina, and Golestan hospitals in Ahwaz, Iran. 72 samples of microbial parameters and 24 samples of chemical parameters were collected from water used in hemodialysis instruments, including microbial characteristics (the total coliform, fecal coliform and heterotrophic bacteria counts) and chemical characteristics (pH, turbidity, PO4, Cl, Mg, So4, Ca, NO2, and EC) at Razi, Imam, and Golestan educational hospitals on all weekdays during 2018-2019. In this study, experiments were done according to the current standard methods, EPA from hemodialysis instruments. Finally, using SPSS18 software and descriptive statistics, the relationship between results at the removal of toxic, microbial, and chemical pollutants in different months and hospitals was investigated. this study showed that the average concentration of chemical characteristics during the warm season at Razi, Imam, and Golestan educational hospitals for pH, Turbidity, PO4, Cl, Mg, So4, Ca, NO2, and EC were (6.867, 6.4475, 6.53); (2.985, 3.035, 1.226); (0.075, 0.245, 0.195); (38.5, 21.965, 144.87); (1.552, 1.657, 39.445); (8.6, 4.5, 21.5), (2.09, 3.187, 78.975); (0.0082, 0.038, 0.155), and (125.25, 70.35, 78.35), respectively during 2018. Also, during 2019, results showed that the average levels of amounts for pH, Turbidity, PO4, Cl, Mg, So4, Ca, NO2, and EC in Razi, Imam, and Golestan educational hospitals were (7.077, 7.252, 6.435), (1.725, 0.595, 4.16), (0.0775, 0.0597, 0.0297), (52.33, 138.81, 20.92), (23.52, 18.227, 8.767), (35, 27.25, 4.05), (14.58, 28.152, 9.25), (0.0067, 0.0045, 0.0032), and (210.52, 121.62, 29.16), respectively. According to the results, hemodialysis instruments in Razi and Imam have a 90% efficiency in removing heterotrophic bacteria counts (HPC). Based on these findings, educational hospital hemodialysis equipment effluent in Ahvaz, Iran was mitted to Iran environmental standards for use in hemodialysis machines. The result showed that the removal percentage level of microbial and chemical pollutants by the hemodialysis process is comparatively suitable. It should be mentioned that in the proper operation and reconstruction, hemodialysis systems can have an increased rate of removal of microbial and chemical pollutants.

Health Endpoint of Exposure to Criteria Air Pollutants in Ambient Air of on a Populated in Ahvaz City, Iran.

The presence of criteria air pollutants (CAP) in the ambient air of a populated inhalation region is one of the main serious public health concerns. The present study evaluated the number of cardiovascular mortalities (CM), hospital admissions with cardiovascular disease (HACD), and hospital admissions for respiratory disease (HARD) due to CAP exposure between 2010 and 2014. The study used the Air Q model and descriptive analysis to investigate the health endpoint attributed to the ground level of ozone (O3), nitrogen dioxide (NO2), sulfide dioxide (SO2), and particle matter (PM10). Baseline incidence (BI) and relative risk (RR) are the most important factors in the evaluation of health outcomes from exposure to CAP in the ambient air of a populated area according to EPA and the World Health Organization (WHO) guidelines. Our study showed that annual cases of cardiovascular mortality during the period 2010-2014 relating to particle mater were 478, 506, 469, 427, and 371; ozone was 19, 24, 43, 56, and 49; nitrogen dioxide was 18, 20, 23, 27, and 21; and sulfide dioxide was 26, 31, 37, 43 and 11, in the years 2010 to 2014, respectively. These results indicate that the number of hospital admissions for respiratory disease attributed to PM were 2054, 2277, 2675, 2042, and 1895; O3 was 27, 35, 58, 73, and 63; NO2 was 23, 24, 15, 25, and 18; and SO2 was 23, 24, 25, 30, and 20, in the years from 2010 to 2014, respectively. The results also showed that the number of hospital admissions for cardiovascular disease related to particle mater was 560, 586, 529, 503, and 472; ozone was 22, 32, 38, 55, and 51; nitrogen dioxide was 19, 18, 13, 21, and 14; and sulfide dioxide was 12, 14, 16, 22, and 9, in the same period, respectively. Observations showed that most of the pollution was from outdoor air and in the human respiratory tract. Increased levels of sulfide dioxide, particle matter, nitrogen dioxide, and ozone can cause additional morbidity and mortality for exposed populations. According to the results, it is possible to help increase the level of public health. The use of these findings could also be of great help to health professionals and facilitators at regional and national levels.

Relationship between the number of hospitalized cardiovascular and respiratory disease and the average concentration of criteria air pollutants (CAP) in Ahvaz.

This study aims to investigate the relationship between the number of hospitalized cardiovascular and respiratory patients and the average concentration of criteria air pollutants, including NO2, SO2, CO, O3 and PM10 in Ahvaz in the period of 10 years (2007-2017). Data on referrals and the number of hospitalized cardiovascular and respiratory patients and also on air pollutants are obtained through Hospital Information System and air quality monitoring stations including Department of Environment Protection Station, Naderi Square Station, University Square Station and the Meteorological Organization Station. The data were analyzed by SPSS version 4 and Poisson distribution regression model to evaluate the effects of each pollutant and the rate of hospitalization. In this study, confidence interval and the significance level are considered at 95% and 5%, respectively. Changes in air pollution indices and number of patients with cardiovascular diseases were evaluated using Excel, Stata and ARIMA models. Based on the results of Poisson regression analysis, there was a significant relationship between the average concentration of NO2, O3, CO and SO2 and hospitalization of patients with cardiovascular disease, with a confidence level of less than 5%. This was the case with NO2 more than other pollutants. Furthermore, there was a significant relationship between the average concentrations of NO2, CO and O3 and the hospitalization rate of patients with respiratory problems and a confidence level of 5%. The effect of NO2 was also higher here. Due to the results, NO2, CO, and O3 had a significant direct correlation with cardiovascular and respiratory rates. The effect of NO2 has been higher than other pollutants. In the study of time intervals of patients with cardiovascular, the results of time-interval analysis indicate the relationship between cardiovascular clients with the "t" time of 7 days earlier and NO2 as a pollutant. The results of this analysis also revealed the relationship between respiratory patients at the time "t" up to 7 days before and O3.

Molecular evolution and phylodynamics of hepatitis B virus infection circulating in Iran.

Previous local and national Iranian publications indicate that all Iranian hepatitis B virus (HBV) strains belong to HBV genotype D. The aim of this study was to analyze the evolutionary history of HBV infection in Iran for the first time, based on an intensive phylodynamic study. The evolutionary parameters, time to most recent common ancestor (tMRCA), and the population dynamics of infections were investigated using the Bayesian Monte Carlo Markov chain (BMCMC). The effective sample size (ESS) and sampling convergence were then monitored. After sampling from the posterior distribution of the nucleotide substitution rate and other evolutionary parameters, the point estimations (median) of these parameters were obtained. All Iranian HBV isolates were of genotype D, sub-type ayw2. The origin of HBV is regarded as having evolved first on the eastern border, before moving westward, where Isfahan province then hosted the virus. Afterwards, the virus moved to the south and west of the country. The tMRCA of HBV in Iran was estimated to be around 1894, with a 95% credible interval between the years 1701 and 1957. The effective number of infections increased exponentially from around 1925 to 1960. Conversely, from around 1992 onwards, the effective number of HBV infections has decreased at a very high rate. Phylodynamic inference clearly demonstrates a unique homogenous pattern of HBV genotype D compatible with a steady configuration of the decreased effective number of infections in the population in recent years, possibly due to the implementation of blood donation screening and vaccination programs. Adequate molecular epidemiology databases for HBV are crucial for infection prevention and treatment programs.

Evolution of hepatitis B virus surface gene and protein among Iranian chronic carriers from different provinces.

BACKGROUND AND OBJECTIVES: Iranian chronic HBV carrier's population has shown a unique pattern of genotype D distribution all around the country. The aim of this study was to explore more details of evolutionary history of carriers based on structural surface proteins from different provinces. MATERIALS AND METHODS: Sera obtained from 360 isolates from 12 Different regions of country were used for amplification and sequencing of surface proteins. A detailed mutational analysis was undertaken. RESULTS: The total ratio for Missense/Silent nucleotide substitutions was 0.96. Sistan and Kermanshah showed the lowest rate of evolution between provinces (P = 0.055). On the other hand, Khorasan Razavi and Khoozestan contained the highest ratio (P = 0.055). The rest of regions were laid between these two extremes. Azarbayjan and Guilan showed the highest proportion of immune epitope distribution (91.3% and 96%, respectively). Conversely, Sistan and Tehran harbored the least percentage (66.6% and 68.8%, respectively). Kermanshah province contained only 5.2%, whereas Isfahan had 54.5% of B cell epitope distribution. In terms of T helper epitopes, all provinces showed a somehow homogeneity: 22.58% (Fars) to 46.6% (Khuzestan). On the other hand, distribution of substitutions within the CTL epitopes showed a wide range of variation between 6.6% (Khuzestan) and 63% (Kermanshah). CONCLUSION: Further to low selection pressure found in Iranian population, the variations between different regions designate random genetic drift within the surface proteins. These finding would have some applications in terms of specific antiviral regimen, design of more efficient vaccine and public health issues.

Drug-related mutational patterns in hepatitis B virus (HBV) reverse transcriptase proteins from Iranian treatment-naïve chronic HBV patients.

BACKGROUND: Immunomodulators and Nucleotide analogues have been used globally for the dealing of chronic hepatitis B virus (HBV) infection. However, the development of drug resistance is a major limitation to their long-term effectiveness. OBJECTIVES: The aim of this study was to characterize the hepatitis B virus reverse transcriptase (RT) protein variations among Iranian chronic HBV carriers who did not receive any antiviral treatments. MATERIALS AND METHODS: Hepatitis B virus partial RT genes from 325 chronic in active carrier patients were amplified and directly sequenced. Nucleotide/amino acid substitutions were identified compared to the sequences obtained from the database. RESULTS: All strains belonging to genotype D.365 amino-acid substitutions were found. Mutations related to lamivudine, adefovir, telbivudine, and entecavir occurred in (YMDD) 4% (n = 13), (SVQ) 17.23% (n = 56), (M204I/V + L180M) 2.45% (n = 8) and (M204I) 2.76% (n = 9) of patients, respectively. CONCLUSIONS: RT mutants do occur naturally and could be found in HBV carriers who have never received antiviral therapy. However, mutations related to drug resistance in Iranian treatment-naïve chronic HBV patients were found to be higher than other studies published formerly. Chronic HBV patients should be monitored closely prior the commencement of therapy to achieve the best regimen option.