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SUMMARY: Hepatitis C virus (HCV) infection is common among patients undergoing haemodialysis, and liver disease is an important cause of morbidity and mortality in this population. Management of HCV-related liver disease is a major health concern in patients with end-stage renal disease (ESRD) undergoing haemodialysis. To investigate the prevalence of HCV infection in patients on haemodialysis and its associated risk factors, we conducted a prospective case series study of 838 patients on haemodialysis in Tehran, Iran. Patients were selected randomly (cluster sampling) and all were screened for anti-HCV antibodies, using ELISA 3rd generation and confirmed by using RIBA 2nd generation. We found that 111 patients (13.2%) were infected. By applying univariate analysis, longer duration on haemodialysis (P = 0.000), more weekly dialysis sessions (P = 0.03), history of blood transfusion (P = 0.03) and history of previous renal transplantation (P = 0.01) were found to be associated with a higher rate of HCV infection. Multivariate analysis revealed that only length of time on dialysis (P = 0.000) and history of blood transfusion (P = 0.02) were significantly associated with HCV infection. The more the units transfused, the higher the rate of HCV infection. Our results suggest that early transplantation and avoidance of blood transfusion, as much as possible, are the two most important practical interventions to reduce the HCV exposure rate in our patients on haemodialysis.

KIDNEY transplantation is the treatment of choice for end-stage renal disease. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients when compared with maintenance dialysis. Renal transplantation has a background of more than 35 years in Iran. More than 12,000 renal transplantations have been performed in this country. We conducted this study to present a brief report of a large number of living donor renal transplants in the two main transplantation centers in Tehran with more than 15 years follow up.

While drilling and completing multilateral wells in unconventional shale plays, a major concern is the stability of the junction. If the junction area is to remain open while producing, the stability of the junction is essential until the end of the well life. Due to the complex geometry of the junction, numerical simulations are typically required to understand the stress concentrations and simulate the stability of the junction. A dual-lateral well was to be drilled and completed in the Montney shale play in Alberta, with the two laterals targeting Middle and Lower Montney, respectively. With the Technical Advancement of Multilaterals (TAML) Level 2 multilateral completion, one lateral would be cased and the other would remain open. Because relatively large drawdown pressures were planned for the well, understanding of the junction stability became an important consideration not only while drilling the lateral, but also while the well was producing. This paper will present a geomechanical analysis of the multilateral junction stability under two drawdown-pressure conditions, including determination of the mechanical properties and in-situ stresses, numerical simulation of the stress concentrations, and rock deformations at the junction.