Background: Lead is an element, which can cross the placenta and enter the fetus during pregnancy if present in the blood of the expectant mother. Therefore, in this study, the level of lead in maternal and umbilical cord blood of neonates was determined, and its relationship with weight at birth, gestational age, height, and head circumference was investigated. Methods: In this cross sectional study, a total of 70 pregnant women and their newborns were selected at Mousavi Hospital of Zanjan, Iran, based on the inclusion criteria. The level of lead in the umbilical cord blood of newborns and mothers was evaluated, and its correlation with birth weight, gestational age, height, and head circumference was assessed. Results: The average level of lead in the maternal and cord blood was 11.01 µg/dL and 9.54 µg/dL, respectively, which indicates a significant difference (P < 0.001). In addition, there was a significant inverse linear relationship between the level of lead in maternal blood and birth weight; therefore, an increase in the maternal blood lead level resulted in the lower weight of neonates at birth. However, there was no significant correlation between lead level and gestational age, height, or head circumference. Conclusions: In this study, the average lead level of pregnant women was 11.01 µg/dL in Zanjan, which is higher than the global standard (10 µg/dL). The birth weight of newborns, whose mothers had higher blood lead levels, was lower than that of other neonates. Therefore, more attention should be paid to the level of lead by the healthcare system in order to take effective measures and reduce lead pollution.
Background: Heart Failure is a pathophysiologic state in which the cardiac output is not able to supply the body with enough oxygen and nutrients. The prevalence of heart failure has increased dramatically over the last decades. Vitamin D levels in patients with chronic heart failure are lower than healthy controls, and vitamin D deficiency has a direct relationship with mortality. Objectives: This study aimed to evaluate the effect of vitamin D on the improvement of left ventricular ejection fraction in patients with systolic heart failure. Methods: In this case-control clinical trial, 142 patients with chronic systolic heart failure were identified. Based on the inclusion and exclusion criteria, 114 patients were enrolled in the study and randomly divided into two groups. One group (n = 58) received 50,000 units of vitamin D capsules weekly for eight weeks, and the patients in the other group (n = 56) received a placebo. After excluding 15 patients from the placebo group and 17 patients from the intervention group during the study, according to the exclusion criteria, 41 patients were evaluated in both groups for ejection fraction changes after two months. Results: According to the results of this research, there were no statistically significant differences in the baseline parameters between the two studied groups. The intervention group consisted of 18 female and 23 male patients with a mean age of 61.68 ± 19.8 years. Moreover, the placebo group included 21 female and 20 male patients with a mean age of 62.12 ± 18.2 years. After a 2-month follow-up, the intervention group showed statistically significant changes in ejection fraction, end-diastolic volume, and heart failure class compared to the placebo group. Also, the serum level of albumin and vitamin D in the intervention group was significantly higher than the placebo group. Conclusions: The results of this study show that vitamin D treatment can improve the ejection fraction and functional ability of patients with vitamin D deficiency. If more comprehensive studies support this hypothesis, vitamin D deficiency assessment and correction in patients with chronic heart failure may be recommended.
Background and Objectives: Knee joint as the largest synovial joint in the body, consists of the lateral collateral ligament, cruciate ligament, and medial and lateral meniscus. For proper management, identification of damage to any structures of the knee is necessary. In this study, snsitivity, specificity, and diagnostic accuracy of high resolution CT scan in meniscal lesions, were assessed. Methods: In this test accuracy assessment study, 57 patients with a history of positive meniscus lesion, who referred to Ayatollah Mousavi Hospital of Zanjan city from 2015 to 2016, were investigated by magnetic resonance imaging, high resolution computed tomography, and arthroscopy. Magnetic resonance imaging and high resolution computed tomography data, were compared to knee arthroscopy as the diagnosis gold standard. Kappa (κ) correlation coefficient was used to calculate the consistency of the tests. Results: Out of the 57 patients presented with meniscal lesion, 52 patients (91.2%) were male and 5 patients (8.8%) were female. The highest incidence of meniscal lesions was in ages from 21 to 30 years. Among the causes of meniscal lesions, exercise with prevalence of 47.9%, was the most prevalent cause of injury. In comparison with arthroscopy, the sensitivity, specificity, and accuracy of high resolution computed tomography were determined to be 64.7%, 55%, and 60%, respectively, and for magnetic resonance imaging were 85.2%, 50%, and 77.5%, respectively. Conclusion: According to the results of the present study, specificity, sensitivity, and accuracy of high resolution computed tomography in the diagnosis of meniscal lesions, was lower than the previous studies.
Conditions other than stenosis also disturb the coronary flow. Such conditions include the coronary slow flow phenomenon, coronary artery ectasia, and coronary artery tortuosity. Evidence exists regarding myocardial dysfunction in these conditions. In this review, we present studies that have used speckle-tracking echocardiography to determine whether coronary flow disturbances are accompanied by myocardial dysfunction. Additionally, we seek to show the gaps in knowledge concerning this issue and the dimensions that future studies should consider.
Background: The coronavirus disease 2019 (COVID-19) global pandemic is a life-threatening condition with high morbidity and mortality rate in Iran. Based on several studies, COVID-19 clinical outcomes are associated with co-morbidities, such as Cardiovascular Diseases (CVD). It appears that there is a relationship between the COVID-19 prognosis and the existence of CVD-related risk factors, for instance hypertension, obesity, diabetes, etc. Methods: A descriptive-analytical cross-sectional study was designed to investigate the relationship between CVD risk factors and COVID-19 with a total of 100 participants in Imam Khomeini hospital, Tehran, Iran. A checklist of anthropometric and prognostic information was filled for each patient and finally the data were analyzed. Results: There was a statistically significant dependence between hospitalization in ICU, reservoir bag-mask, intubation, life-threatening complications, and the final outcome (p<0.01). However, there was no significant correlation between CVD risk factors and prognostic parameters like length of Intensive Care Unit (ICU) hospitalization, the requirement to reserve bag-mask oxygenation, etc. Conclusion: In this investigation, no significant association was observed between CVD-related risk factors and COVID-19 prognosis among Iranian adult COVID-19 cases.
Background: The COVID-19 can cause serious life-threatening complications. Vitamin D deficiency has been proposed to mediate the disease by some studies, however, there is a lack of sufficient data. Methods: In this descriptive-analytical study, 72 Iranian adult patients with COVID-19 were examined. At the beginning of hospitalization, serum levels of vitamin D were checked and patients were divided into four groups as vitamin D above normal, normal, insufficient, or deficient. The prognosis of patients has been evaluated based on serum levels of vitamin D and other underlying factors. Results: Only 30% of patients had normal vitamin D concentrations. Vitamin D status was associated with COVID-19 complications, but not with underlying diseases. In the multivariable logistic regression, COVID-19 prognosis was associated with being male, length of stay in an intensive care unit (ICU), need for intubation, acute respiratory disease syndrome (ARDS), and myocarditis. The serum vitamin D correlated with COVID-19 complications including ARDS, QT length, the requirement to ICU, and intubation. Conclusion: This study showed a mediating role for vitamin D in COVID-19 complications and identified the frequent complications in these patients and contributing variables exaggerating prognosis for health authorities to properly manage COVID-19 in hospitals. Further relevant examinations are highly encouraged.
Generalized pustular psoriasis of pregnancy (GPPP) is a rare dermatosis that usually occurs during the third trimester of pregnancy. The diagnosis is primarily clinical, confirmed by laboratory investigations and histopathological typical findings. Here we report, a 26-year-old, gravida one woman, in 37 weeks of pregnancy, presenting with extensive erythematous, pruritic plaques with peripheral scaling and pustules. Patient was induced at 37+4 weeks and delivered a healthy 2900g male infant. GPPP was eventually controlled with oral cyclosporine.
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