Correlation between hyponatremia and high risk clinical and echocardiographic features in patients with acute heat failure

Background and purpose: Heart failure (HF) is characterized by decreased ability of the heart to provide sufficient blood flow or fill with the blood. Hyponatremia is the most commonly seen electrolyte abnormality in patients with heart failure that is associated with increased morbidity and mortality. The aim of this study was to assess the correlation between hyponatremia and high risk clinical and echocardiographic features in patients with acute HF. Materials and methods: This cross-sectional analytic study was performed in 271 patients with acute systolic heart failure admitted to Sari Fatemeh Zahra hospital, 2018-2019. Patients were divided into two groups: hyponatremic and normonatremic groups. Vital signs, echocardiographic variables, body mass index (BMI), and common cardiovascular risk factors were compared between the two groups using SPSS V18. Results: This study included 130 males (48) and 141 females (52) and the patients� mean age was 69.90±14.02 years. Patients with hyponatremia had lower BMI and systolic and diastolic blood pressure levels and higher platelet counts compared to other group (P =0.01, 0.002, 0.005, and 0.047, respectively). Also, these patients, were found with higher frequency of moderate to severe functional mitral regurgitation (P= 0.076). Linear regression analysis showed hyponatremia as an independent predictor of hypotension and hemodynamic instability in patients with hyponatremia. Conclusion: This study showed that patients with acute HF and hyponatremia are at higher risk of developing hypotension, cachexia, and increased platelet counts which put them at greater risk for cardiovascular morbidity and mortality. © 2020, Mazandaran University of Medical Sciences. All rights reserved

Genomes reveal selective sweeps in kiang and donkey for high-altitude adaptation

Over the last several hundred years, donkeys have adapted to high-altitude conditions on the Tibetan Plateau. Interestingly, the kiang, a closely related equid species, also inhabits this region. Previous reports have demonstrated the importance of specific genes and adaptive introgression in divergent lineages for adaptation to hypoxic conditions on the Tibetan Plateau. Here, we assessed whether donkeys and kiangs adapted to the Tibetan Plateau via the same or different biological pathways and whether adaptive introgression has occurred. We assembled a de novo genome from a kiang individual and analyzed the genomes of five kiangs and 93 donkeys (including 24 from the Tibetan Plateau). Our analyses suggested the existence of a strong hard selective sweep at the EPAS1 locus in kiangs. In Tibetan donkeys, however, another gene, i.e., EGLN1, was likely involved in their adaptation to high altitude. In addition, admixture analysis found no evidence for interspecific gene flow between kiangs and Tibetan donkeys. Our findings indicate that despite the short evolutionary time scale since the arrival of donkeys on the Tibetan Plateau, as well as the existence of a closely related species already adapted to hypoxia, Tibetan donkeys did not acquire adaptation via admixture but instead evolved adaptations via a different biological pathway

Whole-Genome Resequencing of Worldwide Wild and Domestic Sheep Elucidates Genetic Diversity, Introgression, and Agronomically Important Loci

Domestic sheep and their wild relatives harbor substantial genetic variants that can form the backbone of molecular breeding, but their genome landscapes remain understudied. Here, we present a comprehensive genome resource for wild ovine species, landraces and improved breeds of domestic sheep, comprising high-coverage (similar to 16.10x) whole genomes of 810 samples from 7 wild species and 158 diverse domestic populations. We detected, in total, similar to 121.2 million single nucleotide polymorphisms, similar to 61 million of which are novel. Some display significant (P < 0.001) differences in frequency between wild and domestic species, or are private to continent-wide or individual sheep populations. Retained or introgressed wild gene variants in domestic populations have contributed to local adaptation, such as the variation in the HBB associated with plateau adaptation. We identified novel and previously reported targets of selection on morphological and agronomic traits such as stature, horn, tail configuration, and wool fineness. We explored the genetic basis of wool fineness and unveiled a novel mutation (chr25: T7,068,586C) in the 3 '-UTR of IRF2BP2 as plausible causal variant for fleece fiber diameter. We reconstructed prehistorical migrations from the Near Eastern domestication center to South-and-Southeast Asia and found two main waves of migrations across the Eurasian Steppe and the Iranian Plateau in the Early and Late Bronze Ages. Our findings refine our understanding of genome variation as shaped by continental migrations, introgression, adaptation, and selection of sheep

Whole-Genome Resequencing of Worldwide Wild and Domestic Sheep Elucidates Genetic Diversity, Introgression, and Agronomically Important Loci

Domestic sheep and their wild relatives harbor substantial genetic variants that can form the backbone of molecular breeding, but their genome landscapes remain understudied. Here, we present a comprehensive genome resource for wild ovine species, landraces and improved breeds of domestic sheep, comprising high-coverage (∼16.10×) whole genomes of 810 samples from 7 wild species and 158 diverse domestic populations. We detected, in total, ∼121.2 million single nucleotide polymorphisms, ∼61 million of which are novel. Some display significant (P < 0.001) differences in frequency between wild and domestic species, or are private to continent-wide or individual sheep populations. Retained or introgressed wild gene variants in domestic populations have contributed to local adaptation, such as the variation in the HBB associated with plateau adaptation. We identified novel and previously reported targets of selection on morphological and agronomic traits such as stature, horn, tail configuration, and wool fineness. We explored the genetic basis of wool fineness and unveiled a novel mutation (chr25: T7,068,586C) in the 3'-UTR of IRF2BP2 as plausible causal variant for fleece fiber diameter. We reconstructed prehistorical migrations from the Near Eastern domestication center to South-and-Southeast Asia and found two main waves of migrations across the Eurasian Steppe and the Iranian Plateau in the Early and Late Bronze Ages. Our findings refine our understanding of genome variation as shaped by continental migrations, introgression, adaptation, and selection of sheep

Total delay and associated factors in pulmonary tuberculosis patients in Golestan province

Background: Delay in diagnosis and treatment of TB is a critical component in TB control program which thereby spreading illness in the community. Sicnce Golestan province has the high risk with high rates of tuberculosis in the country, therefore, the analysis of the factors associated with treatment delay in this province for effective interventions and proper planning is considered necessary. Methods: 689 patients documents of TB cases in the health department of Golestan University of Medical Sciences in 2016 were enrolled in this survey. The response variable in this study was having the delay or not (via determining the 34 day as cut-off point in the interval between the date of onset of the symptoms and the date of treatment start-up). The data were analyzed using SPSS 24 software and final significant level for multivariate logistic regression model was considered 0.05. Results: Median (mean) treatment delay was calculated 49(77.75) days. In the current study 60.4 of patients had total delay greater than 34 days. In final model variables such as type of PTB (OR=0.645), contact history (patients who had no contact with TB patients (OR=1.441)) and patients who their contact history were unknown (OR=1.654)) had significant relationship with delay in starting treatment after 34 days of onset of symptoms of PTB patients in Golestan (p<0.05). Conclusion: It should beam emphasis on increasing the community's awareness of the symptoms of tuberculosis and effective collaboration should be made between the Infectious Disease Control Center and the private and public sectors. © 2020 Babol University of Medical Sciences. All rights reserved

A study on the Rate of Knowledge, Attitude and Practice of Medical Students towards Method of Medical Records Documentation at Mazandaran University of Medical Sciences Affiliated Therapeutic and Teaching Centers 2003

Background and Objectives: History, clinical findings, procedures undertaken, and patients response to treatment are written in clinical records, hence their contents are indicators of physicians’ evaluation. If clinical records are provided precisely, clear and systematized, they indicate the clinical thinking of the staff and facilitate patients diagnosis process. These records have an important role in coordinating professional staff involved in patient care. Since the physicians and medical students are involved more in medical records documentation than the other hospital staff, thus, a study on their knowledge, attitude and practice towards the principles of medical records documentation is undertaken.Materials and Methods: This is a descriptive study, which is done about the rate of knowledge, attitude and practice of 207 Medical students of Mazandaran University of Medical Sciences in university hospitals. Descriptive and inferential statistical analytic methods were used for the collected data. For comparison of the hospitals, regarding observing designed principals in the completion of medical files, according to the filled questionnaires the minimum and maximum score designated as 1-5 which is very poor to excellent. Then the mean score was calculated and considered for the comparison of hospitals. For the determination of the relationship between knowledge, attitude, and practice, β Kendall’s Tau Test was used.Results: The majority of the participants had low knowledge (77.8%) about medical records documentation. Most of them did not have good attitude (54.1) about completion of medical records and significance and value of medical records documentation in treatment, education, and research.Conclusion: Results indicate that incompletion of medical records at the university affiliated hospitals are due to lack of awareness of the students towards the method of medical records documentation. In addition, not considering the completion of records in evaluation of the students can affect their practic

Evaluation of Influential Factors in the Incidence Period of Cytomegalovirus after Renal Transplantation

BACKGROUND AND OBJECTIVES: Cytomegalovirus (CMV) infection is one of the most frequent infectious complications, which results in renal transplant failure. In this study, we aimed to evaluate the demographic characteristics and risk factors associated with the incidence period of CMV infection after renal transplant. METHODS: This cross-sectional study was conducted in renal transplant recipients during 2010-2015 in kidney transplant unit of Shahid Beheshti Hospital of Babol, Iran. The evaluated demographics included body mass index (BMI), smoking status, type of underlying disease leading to end-stage renal disease, hepatitis B, hepatitis C, and type of dialysis. Data analysis was performed using Kaplan-Meier estimator, log-rank test, and Cox regression. FINDINGS: In total, 242 patients received renal transplant, among whom 73 (30.2%) cases had CMV infection with median and mean survival of 41 and 48.09±23.50, respectively. In this study, there was no correlation between demographic variables (e.g., gender, place of residence, marital status, educational level, BMI, smoking status, hepatitis B, and type of dialysis) and incidence period of CMV. However, a significant relationship was observed between the incidence period of CMV and age (mean: 45 years, P=0.04), as well as etiology of ESRD urology (P=0.03). CONCLUSION: The prevalence of CMV infection is reported to be high in elderly patients with history of urologic diseases. Therefore, performing short-term follow-ups four months after transplantation, with emphasis on the first two months is recommended

Genetic diversity and antifungal susceptibility patterns of aspergillus nidulans complex obtained from clinical and environmental sources

The molecular epidemiology and antifungal susceptibility of Aspergillus nidulans species complex has not been well studied. To evaluate the genetic diversity and antifungal susceptibility patterns of clinical and environmental isolates of A. nidulans complex. Sixty clinical and environmental isolates of Aspergillus section Nidulantes were collected from five countries (Iran, The Netherlands, Spain, Portugal and Greece). The species were molecularly identified by sequencing of β-tubulin gene. The genetic diversity of A nidulans complex isolates (n = 54) was determined with a microsatellite genotyping assay. Antifungal susceptibility profile was determined using EUCAST method. The isolates were classified as A nidulans (46.7%), A spinulosporus (26.6%), A quadrilineatus (10%), A pachycristatus (3.3%), A rugulosus (3.3%), A unguis (5%), A creber, (1.7%), A olivicola (1.7%) and A sydowii (1.7%). Thirty-four sequence types (STs) were identified among the 54 A nidulans complex isolates. A high level of genetic diversity was found among A nidulans sensu stricto strains but low diversity was found among A spinulosporus strains. Amphotericin B showed high MICs to all species. The most active azole was posaconazole (GM = 0.64 mg/L), while itraconazole showed the highest MICs among azoles (GM = 2.95 mg/L). A spinulosporus showed higher MICs than A nidulans sensu stricto for all antifungals except for micafungin and anidulafungin. Interspecies variations may result in differences in antifungal susceptibility patterns and challenge antifungal therapy in infections caused by A nidulans. Differences in the distribution of STs or persistence of multiple STs might be related to the sources of isolation and niche specialisation. © 2019 Blackwell Verlag GmbH