Background: Hepatitis B virus (HBV) is among the leading causes of liver cirrhosis worldwide. Predictors of cirrhosis in Iranian chronic hepatitis B (CHB) patients are yet to be clearly identified.
Background Corona Virus Disease 2019 (COVID-19) presentations range from those similar to the common flu to severe pneumonia resulting in hospitalization with significant morbidity and/or mortality. In this study, we made an attempt to develop a predictive scoring model to improve the early detection of high risk COVID-19 patients by analyzing the clinical features and laboratory data available on admission. Methods We retrospectively included 480 consecutive adult patients, aged 21–95, who were admitted to Faghihi Teaching Hospital. Clinical and laboratory features were collected from the medical records and analyzed using multiple logistic regression analysis. The final data analysis was utilized to develop a simple scoring model for the early prediction of mortality in COVID-19 patients. The score given to each associated factor was based on the coefficients of the regression analyses. Results A novel mortality risk score (COVID-19 BURDEN) was derived, incorporating risk factors identified in this cohort. CRP (> 73.1 mg/L), O2 saturation variation (greater than 90%, 84–90%, and less than 84%), increased PT (> 16.2 s), diastolic blood pressure (≤ 75 mmHg), BUN (> 23 mg/dL), and raised LDH (> 731 U/L) were the features constituting the scoring system. The patients are triaged to the groups of low- (score < 4) and high-risk (score ≥ 4) groups. The area under the curve, sensitivity, and specificity for predicting mortality in patients with a score of ≥ 4 were 0.831, 78.12%, and 70.95%, respectively. Conclusions Using this scoring system in COVID-19 patients, the patients with a higher risk of mortality can be identified which will help to reduce hospital care costs and improve its quality and outcome.
Introduction: The present study was conducted to evaluate the wound healing effect of Arnebia euchroma (AE) extract, which is traditionally used in some Indian, Chinese, and Iranian tribes, on histomorphometrical parameters involved in the healing process of third-degree burn wounds by using stereological analyses. Methods and Materials: In an experimental study, 48 female Sprague-Dawley rats, each with a standard third-degree burn wound on the posterior surface of the neck, were divided into four groups; AE10 and AE20 groups were treated with carboxymethylcellulose (CMC) gels which contained AE hydroalcoholic extract at the concentration of 10% and 20%, respectively; the untreated burned (UB) group, which received no treatment; and the gel-base treated group. Wound closure rate, fibroblast proliferation, volume density of collagen bundles, length density, and mean diameter of the vessels were measured. Results: Wound closure rate, fibroblast population, volume density of collagen bundles, and length density of vessels were significantly improved by AE10 and AE20 in comparison with the gel-base and UB groups (P value <0.05). Conclusion: Although previous investigations on the different aspects of the wound healing effects of AE and the results of this study exhibited the positive effects of topical Arnebia euchroma on third-degree burn wound, introducing AE as an alternative wound healing agent requires more investigations on its efficacy on human, safety, and possible adverse effects.[GMJ. 2012;1(2):53-59]
Material and methodology Authors have studied the seasonal distribution of the gastroenteritis caused by rotavirus. The study was prospective and was conducted at the Department of Pediatric Gastroenterology of the University Clinical Center of Kosova, during one year. Testing of the stool was performed using agglutination test with the sensitivity and specify of around 96%. Results Of 1011 children aged 0-5 years, hospitalized at the Department of Pediatric Gastroenterology due to gastroenteritis, 116 had rotavirus infection. At the admission all children were with diarrhea, 97.41% had vomiting and 43.96% had fewer. 70.7% of patients had moderate dehydration and 29.3% severe dehydration All patients in the study were intravenously rehydrated. All patients healed with no sequels. The seasonality of the disease was distinctive and had two peaks -first in late winter/early spring (January-16, February-9, March-9 and second in late summer/early autumn) August-11, September-20 and October-14. Conclusion Two peaks seasonality late winter/early spring and late summer/early autumn of the rotavirus infection reflects the difference in the wealth of the population in Kosova, with first peak in winter, similar to the one in the developed countries and the second peak in summer, similar to the one in non-developed countries. CLINICO-EPIDEMIOLOGICAL CHARACTERISTICS OF PEDIATRIC ESOPHAGITIS IN SOUTHERN IRAN: A SINGLE CENTER EXPERIENCEdoi:10.1136/archdischild-2012-302724.0691 M Zahmatkeshan, K Najib, B Geramizadeh, E Fallahzadeh, M Haghighat, MH Imanieh. Shiraz University of Medical Sciences, Shiraz, IranObjectives To determine the clinico-epidemiological characteristics of pediatric esophagitis in southern Iran. Methods A cross-sectional study was conducted during a 4-year period from 2005 to 2009 in Nemazee hospital, a tertiary healthcare center in Shiraz, southern Iran. We consecutively included all the pediatric patients (< 18 years) who underwent endoscopy in our center and had pathology-confirmed diagnosis of esophagitis. Data regarding the patients' demographic characteristics, comorbidities, and clinical findings were recorded using a questionnaire. All the patients underwent upper GI endoscopy and biopsy of the esophagus and the findings were recorded in the questionnaire. Results We studied 125 children among whom there were 61 (48.8%) girls and 64 (51.2%) boys with mean age of 6.6±5.5 years. Intractable vomiting was the prominent symptom in our series being reported by 75 (60%) patients followed by fever in 35 (28%). Erythema (33.6%), esophageal ulcer (11.2%), and whitish patch (8.0%) were the most common endoscopic findings while reflux esophagitis (32.8%), chronic (6.4%) and acute esophagitis (5.6%), and candida esophagitis (5.6%) were the most common histological diagnoses. Just 1 (0.8%) patient was diagnosed as having eosinophilic esophagitis, aspergillosis, and graft versus host disease. Conclusion Reflux is the most common cause of esophagitis in the pediatric population of southern Iran. Despite previous rep...
Background: Public trust in the healthcare system is a critical necessity of management in public health crises such as the COVID-19 pandemic. To rapidly assess the public trust in the healthcare system during the COVID-19 epidemic and its correlates in Iran.Methods: A cross-sectional rapid assessment was conducted in Iran during the COVID-19 epidemic in the country. A probability proportional to size multistage random sampling was applied. Sampling was done in 15 provinces. We collected data on public perceived fear, public trust in health system and socio-demographics. Ordinary least square regression modeling was applied to identify correlates of public trust.Results: A total of 5250 adults (response rate: 76%) were participated in the study. Mean of reported trust scores was 50.3±22.8, and of fear scores was 72.0±17.8. Being male (p=0.006), higher levels of education (p<0.001) and socio-economic status (p<0.001), and higher fear scores (p<0.001) were independently correlated with trust in healthcare system. Conclusion: At the time of the COVID-19 epidemic in Iran, public trust in healthcare system is low. A dynamic public epidemic communication with appropriate strategies to communicate with higher social classes is urgent in Iran. Rapid assessments to identify appropriate strategies are needed. These results might be generalizable to the other similar countries during the COVID-19 pandemic.
Purpose Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I 2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I 2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I 2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I 2 = 0%). Conclusion Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment. Supplementary Information The online version contains supplementary material available at 10.1007/s12281-022-00439-9.
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