Investigating the relationship between the level of serum albumin and body mass index, as nutritional indicators, with dialysis adequacy in patients under hemodialysis

BACKGROUND: Patients with end-stage renal disease (ESRD) who undergo hemodialysis have many complications; one of the most important of which is malnutrition, which affects these patients’ quality of life. The aim of this study was to evaluate serum albumin and body mass index (BMI) as nutritional indicators, and their relationship with dialysis adequacy in patients under hemodialysis.METHODS: In this study, 100 patients who underwent hemodialysis in Razi Hospital, Qaemshahr City, Iran, in 2016 were selected via convenience sampling method. The data were collected using demographic questionnaire, albumin test, and measuring height and weight of patients. Data were analyzed using linear regression and correlation coefficient tests.RESULTS: The correlation between the hemodialysis adequacy with albumin was 0.634, which was significant (P < 0.050). For the second hypothesis, the quality of dialysis with BMI was not positively correlated. The correlation between the hemodialysis adequacy with BMI was -0.007, which was not significant (P > 0.050). Although, in the third hypothesis, the regression between the adequacy of hemodialysis, as a dependent variable, and serum albumin and BMI, as independent variables, indicated significant relationship between serum albumin and hemodialysis adequacy; but there was no significant relationship between BMI and adequacy of hemodialysis.CONCLUSION: Adequacy of hemodialysis is in relationship with malnutrition and improving the KT/V dialysis adequacy may have a significant effect on the malnutrition control in these patients

Evaluation of epidemiologic, clinical, and paraclinical features of children with brucellosis hospitalized in two teaching hospital related to Mazandaran University of Medical Sciences, Iran, during the years 2010-2016

BACKGROUND: The clinical manifestations of brucellosis are very diverse. This study was conducted to investigate the epidemiological, laboratory, and clinical characteristics in pediatrics patients with brucellosis.METHODS: In this descriptive cross-sectional study, the population included patients under age of 18 years who were hospitalized with a diagnosis of brucellosis in Razi hospital, Qaemshahr City, and Bu-ali Sina hospital, Sari City, Iran, during the years 2010-2016. Twenty seven patients with a mean age of 12.5 years including 9 girls and 18 boys had inclusion criteria and entered to study. Most patients (70.3%) were in the age range of 12-18 years.RESULTS: Twenty one patients (77.8%) consumed unpasteurized dairy products and 10 patients (37%) had direct contact with livestock. Most of the initial complaints were fever in 13 cases (48.1%), joint pain in 12 cases (44.4%), and limbs pain in 5 cases (18.5%). The most common clinical findings were arthritis (14.8%) and splenomegaly (7.4%). In laboratory findings, 11.1% had leukopenia, 48.1% had anemia, 3.7% had thrombocytopenia, 29.6% had a moderate increase in erythrocyte sedimentation rate (ESR), 25.9% had high increase in ESR, and 18.5% had leukocytosis. Clinical signs and laboratory parameters in the study included chills and fever, joints and limbs pain, arthritis, splenomegaly, increase in ESR, anemia, leukocytosis, and leukopenia.CONCLUSION: In patients with fever and skeletal or joints pain, brucellosis should be considered as a possible disease, and initial diagnostic measures should be taken, especially in children. Signs and symptoms of brucellosis are various and nonspecific. Educating the high risk families plays an important role in management of disease.

The relationship between the adequacy of hemodialysis and laboratory parameters

BACKGROUND: The present study was conducted in order to evaluate the factors affecting the adequacy of dialysis and determine the relationship of dialysis adequacy with laboratory parameters. METHODS: This descriptive study was performed on 60 hemodialysis patients of Razi Medical Center of Qaemshahr, Iran, with the history of more than 3 months of dialysis. The participants were selected using census method. Data collection was conducted through a researcher-made questionnaire. Blood samples were collected to evaluate laboratory parameters. The adequacy of dialysis was calculated through the Kt/V parameter. The obtained data were analyzed using descriptive statistical tests. RESULTS: According to the Kt/V criteria, the mean dialysis adequacy index was 1.6 ± 0.22 and 41.7% of the patients had the optimum dialysis adequacy (Kt/V of greater than 1.2), and 43.3% of patients had a dialysis adequacy which was close to the desirable level. There was a significant reverse relationship between dialysis adequacy and alkaline phosphatase (ALP), blood sugar, and body mass index (BMI). Nevertheless, there was no significant relationship between dialysis adequacy and parathyroid hormone ‎(PTH), cholesterol, triglycerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), calcium, phosphorus, and the number of dialysis sessions per week, duration of each dialysis session, and the history of dialysis (P > 0.05). CONCLUSION: In order to increase the adequacy of dialysis, the blood sugar level of patients should be controlled and patients should be advised to modify their weight using a suitable diet

The relationship between the adequacy of hemodialysis and laboratory parameters

BACKGROUND: The present study was conducted in order to evaluate the factors affecting the adequacy of dialysis and determine the relationship of dialysis adequacy with laboratory parameters.METHODS: This descriptive study was performed on 60 hemodialysis patients of Razi Medical Center of Qaemshahr, Iran, with the history of more than 3 months of dialysis. The participants were selected using census method. Data collection was conducted through a researcher-made questionnaire. Blood samples were collected to evaluate laboratory parameters. The adequacy of dialysis was calculated through the Kt/V parameter. The obtained data were analyzed using descriptive statistical tests.RESULTS: According to the Kt/V criteria, the mean dialysis adequacy index was 1.6 ± 0.22 and 41.7% of the patients had the optimum dialysis adequacy (Kt/V of greater than 1.2), and 43.3% of patients had a dialysis adequacy which was close to the desirable level. There was a significant reverse relationship between dialysis adequacy and alkaline phosphatase (ALP), blood sugar, and body mass index (BMI). Nevertheless, there was no significant relationship between dialysis adequacy and parathyroid hormone ‎(PTH), cholesterol, triglycerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), calcium, phosphorus, and the number of dialysis sessions per week, duration of each dialysis session, and the history of dialysis (P > 0.05).CONCLUSION: In order to increase the adequacy of dialysis, the blood sugar level of patients should be controlled and patients should be advised to modify their weight using a suitable diet

Investigating the relationship between the level of serum albumin and body mass index, as nutritional indicators, with dialysis adequacy in patients under hemodialysis

BACKGROUND: Patients with end-stage renal disease (ESRD) who undergo hemodialysis have many complications; one of the most important of which is malnutrition, which affects these patients’ quality of life. The aim of this study was to evaluate serum albumin and body mass index (BMI) as nutritional indicators, and their relationship with dialysis adequacy in patients under hemodialysis. METHODS: In this study, 100 patients who underwent hemodialysis in Razi Hospital, Qaemshahr City, Iran, in 2016 were selected via convenience sampling method. The data were collected using demographic questionnaire, albumin test, and measuring height and weight of patients. Data were analyzed using linear regression and correlation coefficient tests. RESULTS: The correlation between the hemodialysis adequacy with albumin was 0.634, which was significant (P 0.050). Although, in the third hypothesis, the regression between the adequacy of hemodialysis, as a dependent variable, and serum albumin and BMI, as independent variables, indicated significant relationship between serum albumin and hemodialysis adequacy; but there was no significant relationship between BMI and adequacy of hemodialysis. CONCLUSION: Adequacy of hemodialysis is in relationship with malnutrition and improving the KT/V dialysis adequacy may have a significant effect on the malnutrition control in these patients

The predictive value of C-reactive protein (CRP) and procalcitonin chemical biomarkers in the premature diagnosis of infection in brain ischemic stroke

BACKGROUND: The infections are common complications after the ischemic stroke. The aim of this study was to evaluate the anticipatory value of C-reactive protein (CRP) and procalcitonin (PCT) biomarkers in diagnosis of stroke-induced infection.METHODS: In the current prospective study, 184 patients with cerebral ischemia were enrolled. Serum samples were obtained from patients. The CRP and PCT, white blood cells (WBCs) and monocytes, and final infections were evaluated.RESULTS: In the first 72 hours, the analysis for CRP revealed that the sensitivity was 41.60%, the specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 82.90%. PCT showed that the sensitivity was 85.41%, the specificity was 98.54%, PPV was 95.34%, and NPV was 95%.CONCLUSION: According to our findings, the evaluation of CRP and PCT with simultaneous clinical observation could be considered as a good step in start of antibiotic therapy

Evaluation of epidemiologic, clinical, and paraclinical features of children with brucellosis hospitalized in two teaching hospital related to Mazandaran University of Medical Sciences, Iran, during the years 2010-2016

BACKGROUND: The clinical manifestations of brucellosis are very diverse. This study was conducted to investigate the epidemiological, laboratory, and clinical characteristics in pediatrics patients with brucellosis. METHODS: In this descriptive cross-sectional study, the population included patients under age of 18 years who were hospitalized with a diagnosis of brucellosis in Razi hospital, Qaemshahr City, and Bu-ali Sina hospital, Sari City, Iran, during the years 2010-2016. Twenty seven patients with a mean age of 12.5 years including 9 girls and 18 boys had inclusion criteria and entered to study. Most patients (70.3%) were in the age range of 12-18 years. RESULTS: Twenty one patients (77.8%) consumed unpasteurized dairy products and 10 patients (37%) had direct contact with livestock. Most of the initial complaints were fever in 13 cases (48.1%), joint pain in 12 cases (44.4%), and limbs pain in 5 cases (18.5%). The most common clinical findings were arthritis (14.8%) and splenomegaly (7.4%). In laboratory findings, 11.1% had leukopenia, 48.1% had anemia, 3.7% had thrombocytopenia, 29.6% had a moderate increase in erythrocyte sedimentation rate (ESR), 25.9% had high increase in ESR, and 18.5% had leukocytosis. Clinical signs and laboratory parameters in the study included chills and fever, joints and limbs pain, arthritis, splenomegaly, increase in ESR, anemia, leukocytosis, and leukopenia. CONCLUSION: In patients with fever and skeletal or joints pain, brucellosis should be considered as a possible disease, and initial diagnostic measures should be taken, especially in children. Signs and symptoms of brucellosis are various and nonspecific. Educating the high risk families plays an important role in management of disease

Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male

Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient’s condition and health care setting. This problem can be seen in endemic area in which controlling of TB is hard. Report of the disease in local health care center for desirable treatment and health maintenance is necessary. We explained a rare case of pulmonary TB in a patient that was healthy in other fields and just showed the minimum systemic symptoms. The patient came with a mass in lower part of back of chest cage, with a mild pain. The imaging survey showed EN. Smear and Ziehl-Neelsen stains from subcutaneous aspiration were positive for TB. This case showed importance of clinical view and awareness of this silent but serious disease in endemic area especially for TB

Evaluation of Children with Complication of BCG Vaccination in North of Iran

Background: Although the efficacy of Bacillus Calmette-Guerin (BCG) vaccine in the prevention of tuberculosis has been noted consistently, the use of BCG vaccine is not without risk. In this study we aimed to evaluate immunologically, children with complication of BCG vaccination in North of Iran.Materials and Methods: This case-control study began in 30 Jan 2013 and was completed in 2 Jul 2015. In case group 35 patients with moderate to severe complications of BCG vaccination for Tuberculosis (TB), have been enrolled.Thecontrol group included 35 patients with mild complication and patients had no complications due to BCG vaccine.  Routine and specific tests for evaluation of immunological function were performed.Results: Out of total number of 35 patients in case group, 3(8.6%) patients had severe complication, also they diagnosed as BCG-osis; 32(91.42%) cases had moderate symptoms‎. In the control group 25 (71.4%) patients had mild complications and 10(28.57%) patients had no complications. The mean of IL-23 level in the two groups had significant difference (P= 0.027). There was a significant relationship about interleukin and interferon deficiency among patients with severe complications.  Patients with mild to moderate complications of BCG vaccine were not associated with immunodeficiency. Patients with severe complications of BCG vaccine, were associated with Mendelian susceptibility to mycobacterial disease (MSMD) primary ‎immunodeficiency (PID).Conclusion: Severe complications of BCG vaccine could be due to MSMD and it may be associated with immune ‎deficiency in IL 12/23.‎ BCG vaccination must be deferring in newborns in families with a history of death following presumed BCG or early death or recurrent infection, until suitable screening immunological tests exclude the PID

A 10-year survey on prevalence and occurrence rate of multi-drug resistant Mycobacterium tuberculosis in Latin American and Mediterranean Families: A Systematic review and meta-analysis

Introduction: Latin American and Mediterranean (LAM) is a family of Mycobacterium tuberculosis (M. tuberculosis). Drug resistant in M. tuberculosis LAM family is a major problem in the world population. Our objective of this study was to determine the prevalence of M. tuberculosis LAM family with multi-drug resistant (MDR) in the worldwide by a meta-analysis and systematic review. Materials and methods: Data sources of this study were 68 original articles (2001-2012) which were published in different databases. Research articles with full text in English were selected. Review articles, congress abstracts, studies that were reported in languages other than English and also studies that were not available for us in abstract or full text were excluded. Data that were obtained from prevalence and occurrence rate of MDR M. tuberculosis LAM family were analyzed using meta-analysis random effects models with software package Meta R, Version 2.13 (P < 0.10). Results: During 10 years, lowest rate of prevalence was observed in 2010 and 2006 (95% CI: 5.91%-6.95%) and highest prevalence rate was in 2006 (95% CI: 17.48%- 24.05%). prevalence of MDR- M. tuberculosis analysis showed positive MDR between them (95% CI: 10.30%-11.23%). Prevalence for negative MDR was 9.22% (95% CI: 8.3%- 10.2%). Conclusion: Our study showed that M. tuberculosis LAM family is prevalent in Europian countries. LAM sub lineage was a major focus of studies that carried out in different countries. The proper technique for prevention of transmission of M. tuberculosis is necessary