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Background The safety of continuing Total Joint Arthroplasty (TJA), as an elective procedure, during the pandemic is controversial. The present study aimed to investigate the incidence of symptomatic COVID-19 and its related risk factors in unvaccinated patients after TJA within one month post-discharge in two large cities of our country. Methods The present prospective study included all the patients admitted to three hospitals, located in two high-populated cities of our country from April 1st, 2020, to April 1st, 2021, for elective TJA. Urgent TJA (traumatic fractures) were excluded. The primary outcome was symptomatic COVID-19 within one-month after discharge that was diagnosed using the SARS-CoV-2 RT-PCR test. Afterward, the incidence of the COVID-19 in the study population was compared with the general population to estimate the safety of elective TJA during the pandemic. Results From the 1007 patients undergoing TJA, 755 patients met the inclusion criteria. None of the patients was vaccinated against COVID-19. Among them, 18 patients (2.4%) developed symptomatic COVID-19 within one-month after discharge. In the same time interval, the incidence of COVID-19 was 2.2% in the general population of these two cities, which was similar to the incidence reported in the study population. Of the patients who were positive for COVID-19, four patients were hospitalized, and 3 of them were ICU-admitted; however, no mortality was reported. Conclusion The TJA will be a safe elective procedure for the patients during the pandemic if the preventive protocols are followed strictly.

Background Postpartum depression (PPD) is one of the most important mental disorders in recent years. However, the effects of prenatal sleep disorders on the development of PPD among pregnant women have not been elucidated. This review aims to provide a summary of the literature evaluating the relation between sleep disorders during pregnancy and PPD. Method A systematic literature search was conducted in PubMed, Web of Science, Scopus, Google Scholar, and Embase up to September 2020. All observational studies (cross‐sectional, case–control, and cohort) and studies that assessed the association between sleep disorders during pregnancy and PPD were included. Total sample of 36,873 women from 13 studies was entered to meta‐analysis. An aggregate effect size estimate (odds ratio) was generated using the comprehensive meta‐analysis software. A random effects model was set a priori. Heterogeneity and publication bias were examined using the standard meta‐analytic approaches. Result We found maternal sleep disorder increased odds of PPD (point estimate, 3.300; 95% confidence interval [CI], 2.136–5.098; p < .001; n = 13). However, there was significant heterogeneity (Q, 131.250; df, 12; p < .001; I2, 90.857%). The estimated effect size was significant for all categorical studies. According to meta‐regression, no moderating factor (age and publication year) significantly mediated the estimated effect size. Conclusion We found a significant relationship between sleep disturbances during pregnancy and PPD. Women with sleep disorders are at an increased risk of developing PPD, which warrants screening pregnant mothers for sleep disturbances. Also, we found that the increasing age in pregnancy was associated with increased risk of PPD.

It seems that neonates of mothers with well-controlled GDM are still at increased risk of cardiac hypertrophy, subclinical diastolic dysfunction, and impaired left ventricular relaxation. This can be interpreted that focusing only on glycemic control is not enough to prevent cardiac dysfunction.

Background:The prevalence of obesity is increasing worldwide. Obese children without hypertension are becoming an important health challenge.Aims:Complications of obesity in adults are well established, but in obese children, cardiac dysfunction has not been reported clinically.Settings and Design:The present crosssectional study investigates subclinical systolic and diastolic dysfunction using echocardiographic modalities.Materials and Methods:Twentyfive youngsters with body mass index (BMI) >30 and 25 healthy children with BMI <25 were assigned into case and control group, respectively. In all participants, complete cardiovascular examination, electrocardiography, and echocardiography were fulfilled. Echocardiography surveys included standard, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI).Statistical Analysis Used:SPSS software, version 24.Results:The two groups were matched for age and sex. The resting heart rate and blood pressure were markedly higher in the obese group (P = 0.0001) though they were within the normal range in either category. Ejection fraction in the two groups was similar. Left ventricular (LV) mass (P = 0.0001), LV mass index (P = 0.029), left atrialtoaortic diameter ratio (P = 0.0001), and LV enddiastolic diameter (P = 0.008) were significantly greater in the case group, indicating cardiomegaly and subclinical systolic and diastolic dysfunction. Except for the aortic velocity, all PWD variables were considerably lower in the case group, suggesting subclinical diastolic dysfunction. All TDI parameters varied significantly between the two categories. There was a direct correlation between isovolumetric relaxation time and BMI.Conclusions:Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

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Background:The mitral annular plane systolic excursion (MAPSE) and tricuspid annular plane systolic excursion (TAPSE) are parameters for evaluating systolic function, which is directly affected by ventricular morphology and geometry.Materials and Methods:A cross-sectional study in term and preterm neonates calculated TAPSE and MAPSE at the lateral and septal (LAT/SEP) mitral. The study groups were divided into three classes based on birth age: two preterm groups, 30–33 weeks and 34–37 weeks, and one term group, 38–40 weeks.Results:This study included 21 term neonates and 31 preterm neonates. The mean LAT MAPSE was 0.63 ± 0.11 cm for gestational age (GA) of 30–33 weeks, 0.76 ± 0.03 cm among GA of 34–36 weeks, and 0.84 ± 0.08 cm for GA of 37–40 weeks; the mean SEP MAPSE was 0.39 ± 0.14 cm, 0.51 ± 0.06 cm, and 0.65 ± 0.09 cm, respectively; and the mean TAPSE was 0.47 ± 0.13 cm, 0.62 ± 0.07 cm and 0.88 ± 0.15 cm, respectively. The mean LAT MAPSE was 0.63 ± 0.09 cm for neonates weighing 1500–2500 g and 0.82 ± 0.06 cm for those weighing 2500–3600 g; the mean SEP MAPSE was 0.39 ± 0.11 cm and 0.61 ± 0.09 cm, respectively. The LAT MAPSE showed a positive correlation with body surface area (BSA) and body weight (BW) (P = 0.0001). In addition, the SEP MAPSE indicated a positive correlation with BSA and BW (P = 0.0001). The TAPSE had a positive correlation with BSA (P = 0.0001) and BW (r = 0.876, P = 0.0001).Conclusions:The TAPSE and MAPSE values were calculated to establish the reference values for assessing global ventricular systolic function in neonate's health.