Evaluation of demographic status and related factors in mortality of patients suspected of COVID-19 admitted to Razi Hospital in Rasht

Introduction: SARS-CoV2 is the third strain from Corona family with zoonotic roots which has spread among humans from the beginning of this century. We conducted this study to examine mortality and its related factors among all patients admitted to Razi Hospital with suspicion of COVID-19 between February and April 2020. Materials and Methods: In this analytical cross-sectional study,after obtaining permission from the ethics committee under the university’s research deputy, the required information such as demographic data, clinical symptoms and imaging study results was collected by reviewing records of all patients with COVID-19 suspicion. Results: From 1792 cases, 1045 patients were male and 747 patients were female. Mortality was 27% in all patients and 30% and 22% in men and women. The highest hospitalization rate was in the age group of 51-60 years and the highest mortality rate was in the age group of 81-90 years. 1472 patients lived in urban areas and 316 patients in rural areas. 997 patients had 93% O2 Saturation and less, of which 36% died. PCR test was performed for 505 patients, of which 69% were positive. Chest CT scan was performed in 96% of patients and chest X-ray was performed in 66% of patients with COVID-19.The most common symptoms were shortness of breath, cough, fever, chills, weakness, nausea and headache, respectively. The highest mortality was in patients with impaired consciousness at the beginning of hospitalization. Conclusion: The results of the present study showed that male gender, older age, history of underlying disease, Chest x-ray involvement, drug use, shortness of breath and lesser O2 Saturation are associated with adverse outcomes, constitutional and gastrointestinal symptoms are associated with better outcomes in patients with COVID-19

An anomalous Origin of Left Anterior Descending Coronary Artery from Right Coronary Artery in a Patient with Acute Coronary Syndrome

A double left anterior descending (LAD) coronary artery emerging from the left and right coronary arteries is classified among rare coronary anomalies. We herein report a 73-year-old man presenting with acute coronary syndrome (posterolateral myocardial infarction). He was admitted with typical chest pain, and due to his progressive ischemic changes on electrocardiography (ECG) and elevated cardiac enzyme, he was candidated for cardiac catheterization. The coronary angiography revealed an anomalous LAD from the right sinus of Valsalva. The unusual coronary anatomy was perfectly matched with the distribution of ischemia and its clinical evidence on echocardiography and ECG. The culprit lesion was stented, and the patient was discharged in good physical condition from the hospital

A Case of Double Right Coronary Artery with Separate Ostium

Coronary artery anomalies are rare, with their incidence varying from 1 to 5%. Angiography is a commonly used modality for the assessment of coronary artery anomalies. Based on previous reports, a majority of coronary artery anomalies are of origin or distribution, with separate ostia of the left anterior descending artery and left circumflex artery. Coronary artery anomalies may cause myocardial ischemia secondary to atherosclerosis in the same artery. We present a rare case of duplicated right coronary artery with a separate ostium, which caused myocardial ischemia. Our patient was a 51-year-old diabetic woman with typical chest pain and dyspnea on exertion. Electrocardiography showed left axis deviation, poor R progression, and biphasic T wave in the precordial leads. Echocardiography revealed left ventricular ejection fraction of 30- 35% and global hypokinesia. Coronary angiography demonstrated three-vessel disease and a double ostial right coronary artery. We recommended coronary artery bypass graft surgery, but the patient refused it and we continued her treatment with anti-ischemic drugs

Left ventricular dysfunction: Neither a matter of atherosclerosis nor an anomalous originated right coronary artery from left anterior descending artery

BACKGROUND: Abnormal separation of right coronary artery (RCA) from the left coronary system is an extremely rare variation among coronary artery anomalies. The compressions on the anomalous route of this artery may lead to arrhythmia, chest pain, or left ventricular dysfunction or may enhance formation of atherosclerotic plaques. CASE REPORT: Here, we have reported a patient presented with heart failure who had an anomalous atherosclerotic RCA originating from left anterior descending artery. Interestingly, neither the anomalous origin nor the atherosclerosis was the cause of the patient&rsquo;s problems and she suffered from a hypertensive cardiomyopathy. CONCLUSION: This reminds that encountering an anomaly should not solely be interpreted as the cause of cardiac disease.&nbsp;</p

Investigating the Role of Agricultural Cooperatives in Reducing Production Costs (A Case Study of Potato Cultivators in Ardabil Township)

This research was carried out with the aim of investigating the role of agricultural cooperatives in reducing production costs during Tillage, planting, harvesting and transportation of potatoes in Ardabil.The statistical population of the study consisted of farmers of cooperative and non-cooperative members of potato work in Ardabil city which were selected by random sampling method, 183 farmers. The required information was collected through a survey and completed questionnaires. The results showed that there was a significant difference in total of production costs between cooperatives members and non-members, so that members of the production cooperative was observed at the planting stage, which the cooperatives farmers spent 24% more than non-members. The sum of production costs in the tillage and harvesting stages was not significant. However, members of cooperatives at these stages were 3% and 2% respectively more than non-member farmers. Transportation costs were statistically significant between the two groups of farmers, so that cooperatives' farmers paid less than 22%. The Trans log cost function estimation showed that members of the production cooperatives had more costs than non-member farmers and the hypothesis of homothetic structure of potato production is unacceptable among farmers. By increasing the production level, more use made of seed input and labor, and less use of land and machinery was achieved per hectare. It is suggested that cooperatives participate in a broad and parallel way with the needs of farmers in all stages of production and marketing, and develop and expand their functional fields

Analysis of the Structure and Savings of the Potato Production Scale Using the Translog Cost Function (Ardabil County)

The present study aimed at investigating the production costs and economic benefits of the potato production in Ardabil country, Iran. To do so, 183 potato producers were randomly selected and were asked to present their ideas concerning the production costs and benefits through a questionnaire and an interview. A field study was also taken into consideration to enrich the data. The collected data were analyzed through measures of Chi-square, Wald test, and Translog cost function. The results revealed that the cost function structure was non-hemotetic with respect to the Chi-square statistics (36.8) and results of the constant non-returns and non-homogeneous Wald test to the scale’s F- statistics (17.04) were non-cobb Douglas. Allen cross replacement relationship was positive for the dichotomies such as workforce and machinery, machine and seed, workforce and seed, workforce and water, and finally seed and water. However, it was negative for machinery and land inputs, machinery and water, land and machinery, land and labor force, land and seeds, and land and water. The calculated cost elasticity was -1.5044 which indicated a decrease in the average costs for an output increase as the production cost was found in the downstream part of the cost curve. The economies of scale of 2.504 indicated a 2.5 percent increase in the yield for one-percent increase in the cost

Acute kidney injury after cardiac surgery in the North of Iran

Introduction: Acute renal failure is a well-known complication in patients after cardiac surgery. Objectives: The determination of disease-causing factors with the aim of identifying patients at high-risk and implementing preventive care pre- and postoperatively to reduce the incidence of acute kidney injury (AKI) in patients after cardiac surgery. Patients and Methods: The present cross-sectional research was carried out on 512 adult patients who underwent cardiac surgery between 2015 and 2016 in our tertiary center. Demographic and laboratory data of patients were obtained using a checklist. AKI is defined as an increase of at least 0.3 mg/dL in creatinine (Cr) over 48 hours and one week after surgery according to acute kidney injury network (AKIN) and RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) criteria before surgery. All data were analyzed by SPSS version 1, and P value <0.05 was considered significant. Results: In this study we found, AKI risk profiles including serum Cr level [OR = 3.24, 95% CI = 1.92 -12.48, P = 0.001], fasting blood glucose [OR = 1.22, 95% CI = 1.09 -1.92, P = 0.03] and hemoglobin (Hb) before surgery (OR = 0.59, 95% CI = 0.08 -0.87, P = 0.04) were significantly associated with increased risk of acute renal injury (logistic regression analysis). Conclusion: The results indicated that changes in serum Cr level, fasting blood glucose and plasma Hb before cardiac surgery might be considered as the risk factors for AKI after cardiac surgery

Association between Metabolic syndrome and Subjective social status in coronary artery disease patients, a cross sectional study: Metabolic syndrome and Subjective social status

Aims: The&nbsp; purpose&nbsp; of&nbsp; this&nbsp; study&nbsp; was&nbsp; to&nbsp; examine&nbsp; the&nbsp; association&nbsp; of&nbsp; metabolic&nbsp; syndrome (MetS)&nbsp; with&nbsp; subjective&nbsp; social&nbsp; status (SSS)&nbsp; and&nbsp;&nbsp; depression&nbsp; symptoms&nbsp; among&nbsp; coronary artery disease patients (CAD). Materials and methods: in&nbsp; a&nbsp; cross&nbsp; sectional&nbsp; study&nbsp; during&nbsp;&nbsp; 2019- 2020,&nbsp; patients&nbsp; with&nbsp; CAD&nbsp;&nbsp;&nbsp; older&nbsp; than&nbsp; 30&nbsp; through&nbsp; simple&nbsp; sampling&nbsp; method&nbsp; were&nbsp; selected. SSS&nbsp; and&nbsp; depression&nbsp; were&nbsp; assessed&nbsp; using&nbsp; MacArthur&nbsp; scale&nbsp; and&nbsp; Persian&nbsp; version&nbsp; of&nbsp; the 13&nbsp; items&nbsp; beck&nbsp; depression&nbsp; scale,&nbsp; respectively.&nbsp; The components &nbsp;of&nbsp; Metabolic&nbsp; syndrome,&nbsp; ,&nbsp; and&nbsp; demographic&nbsp; factors&nbsp; were&nbsp; collected&nbsp; based&nbsp; on&nbsp; patients&nbsp; medical&nbsp; records. result: data&nbsp; related&nbsp; to&nbsp; 500&nbsp; CAD&nbsp; patients&nbsp; aged&nbsp; 61.81&nbsp; ±&nbsp; 12.25&nbsp; years&nbsp; were&nbsp; assessed. prevalence of&nbsp; MetS&nbsp; was&nbsp; 57 % . Almost&nbsp; 75%&nbsp; of&nbsp; study&nbsp; subjects&nbsp; were&nbsp; in&nbsp; low&nbsp; category&nbsp; of&nbsp; SSS.&nbsp; Univariate&nbsp; logistic&nbsp; regression&nbsp; analysis&nbsp; showed&nbsp; the&nbsp; odds&nbsp; of&nbsp; MetS&nbsp;&nbsp; in&nbsp; patients&nbsp; with&nbsp; higher&nbsp; SSS&nbsp; was&nbsp; 21%&nbsp; less&nbsp; than&nbsp; patients&nbsp; with&nbsp; lower&nbsp; SSS&nbsp; (OR=0.79, 95% CI=0.53-1.19, P=0.274). The&nbsp; odds&nbsp; of&nbsp; MetS&nbsp; was&nbsp; higher&nbsp; in&nbsp; women [OR=1.67(1.16-2.42)] , married&nbsp; subjects[OR=1.55(0.74-3.26)] , in&nbsp; rural&nbsp; area [OR=1.30(0.88-1.91)] ,&nbsp; those&nbsp; without&nbsp; job [OR=0.83(0.58-1.19)]&nbsp; and&nbsp; literacy[OR= 0.83(0.58-1.19)] . There&nbsp; was&nbsp; no&nbsp; significant&nbsp; association&nbsp; between&nbsp; depression&nbsp; and&nbsp; the&nbsp; odds&nbsp; of&nbsp; metabolic&nbsp; syndrome (OR=0.98,&nbsp; 95%&nbsp; CI= 0.63-1.52, P= 0.950). In&nbsp; multivariate&nbsp; logistic&nbsp; regression&nbsp; analysis&nbsp; ,&nbsp; the&nbsp; inverse&nbsp; association&nbsp; between&nbsp; SSS&nbsp; and&nbsp; MetS&nbsp; was&nbsp; still&nbsp; remained&nbsp; (OR= 0.74, 95% CI=0.49-1.12, P=0.163). Conclusions: MetS&nbsp; was&nbsp; more&nbsp; prevalent&nbsp; in&nbsp; lower&nbsp; even&nbsp; considering&nbsp; demographic&nbsp; factors&nbsp; and&nbsp; depression&nbsp; symptoms. More&nbsp; researches&nbsp; need&nbsp; to&nbsp; assess&nbsp; the&nbsp; effect&nbsp; of&nbsp; perceived&nbsp; social&nbsp; standing&nbsp; on&nbsp; cardiometabolic&nbsp;&nbsp; risk&nbsp; factors

Risk factor control, adherence to medication and follow up visit, five years after coronary artery bypass graft surgery

Introduction: Inadequate adherence to medication and follow up visits were proposed correlated with cardiovascular mortality and complications. This study was planned to evaluate medication and follow up adherence and risk factor control in patients with coronary artery disease 5 years after coronary artery bypass grafting (CABG). Methods: In this retrospective cohort study, adult patients who underwent CABG in 2010 were enrolled. Conventional and probable risk factor control and adherence to medication and follow up visits were assessed. Results: 196 patients were recruited to the study. Uncontrolled blood pressure, blood glucose and low-density lipoprotein (LDL)were reported in 48%, 61% and 32% of patients, respectively. More than 63% of former smokers restarted smoking during 6-12 months after bypass. Poor medication adherence was present in 10.7% in the study population. The last follow up visit time for 30% of patients was later than 12 months after CABG. Conclusion: Poor risk factors control and adherence to follow up visits was common among patients undergoing CABG