Optic Nerve Head Optical Coherence Tomography Angiography Findings after Coronavirus Disease

Purpose: To quantify the microvasculature density of the optic nerve head (ONH) using optical coherence tomography angiography (OCTA) analysis in patients recovered from Coronavirus Disease 2019 (COVID-19). Methods: In a comparative cross-sectional, observational study, patients recovered from COVID- 19 whose initial diagnosis was confirmed by an rRT-PCR of a nasopharyngeal sample were included in this study. OCTA of ONH was performed in included patients and normal controls. Vascular density (VD) of the all vessels (AV) and small vessels (SV) inside the disc and radial peripapillary capillary (RPC) network density was measured in COVID-19 recovered patients and compared with similar parameters in an age-matched group of normal controls. Results: Twenty-five COVID-19 patients and twenty-two age-matched normal controls were enrolled in the study and one eye per participant was evaluated. The mean whole image SV VD in the COVID-19 group (49.31 ± 1.93) was not statistically significantly different from that in the control group (49.94 ±. 2.22; P = 0.308). A decrease in RPC VD was found in all AV and SV VD measured, which became statistically significant in whole peripapillary SV VD, peripapillary inferior nasal SV VD, peripapillary inferior temporal SV VD, peripapillary superior nasal SV VD, and grid-based AV VD inferior sector (P < 0.05). Inside disc SV VD in the COVID-19 group (49.43 ± 4.96) was higher than in the control group (45.46 ± 6.22) which was statistically significant (P = 0.021). Conclusion: Unremarkable decrease was found in ONH microvasculature in patients who had recovered from COVID-19. These patients may be at risk of ONH vascular complications. Increase in inner disc SV VD may be an indicator of ONH hyperemia and edema

A Comparative Analysis of Clinical Characteristics and Laboratory Findings of COVID-19 between Intensive Care Unit and Non-Intensive Care Unit Pediatric Patients: A Multicenter, Retrospective, Observational Study from Iranian Network for Research in Viral

Introduction: To date, little is known about the clinical features of pediatric COVID-19 patients admitted to intensive care units (ICUs). Objective: Herein, we aimed to describe the differences in demographic characteristics, laboratory findings, clinical presentations, and outcomes of Iranian pediatric COVID-19 patients admitted to ICU versus those in non-ICU settings. Methods: This multicenter investigation involved 15 general and pediatrics hospitals and included cases with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive real-time reverse transcription polymerase chain reaction (RT-PCR) admitted to these centers between March and May 2020, during the initial peak of the COVID-19 pandemic in Iran. Results: Overall, 166 patients were included, 61 (36.7%) of whom required ICU admission. The highest number of admitted cases to ICU were in the age group of 1–5 years old. Malignancy and heart diseases were the most frequent underlying conditions. Dyspnea was the major symptom for ICU-admitted patients. There were significant decreases in PH, HCO3 and base excess, as well as increases in creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and potassium levels between ICU-admitted and non-ICU patients. Acute respiratory distress syndrome (ARDS), shock, and acute cardiac injury were the most common features among ICU-admitted patients. The mortality rate in the ICU-admitted patients was substantially higher than non-ICU cases (45.9% vs. 1.9%, respectively; p<0.001). Conclusions: Underlying diseases were the major risk factors for the increased ICU admissions and mortality rates in pediatric COVID-19 patients. There were few paraclinical parameters that could differentiate between pediatrics in terms of prognosis and serious outcomes of COVID-19. Healthcare providers should consider children as a high-risk group, especially those with underlying medical conditions

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

Some Word Formation Processes in Zamyad-Yasht of Avesta : Word Formation in Zamyad-Yasht

The speakers of every language avail themselves word formation processes and analogy to create new words as to be able to express what they intend. What is meant by a word is the mental picture which is shared by all. The present study aimed at examining some word formation processes involved in making adjectives in Zamyad-Yasht. What prompted us to select Yasht 19 from the available Yashts in Avesta was its authenticity and antiquity compared to other Yashts. Zamyad-Yasht, the 19th Yasht in Avesta, comprises 96 parts/sections and is about Farr-e Kyani. The results of the study showed that of the word formation processes, including derivation, compounding, derivation and compounding, clipping, conversion, and reduplication, discussed in this study, derivation and compounding were most frequently observed, respectfully.The speakers of every language avail themselves word formation processes and analogy to create new words as to be able to express what they intend. What is meant by a word is the mental picture which is shared by all. The present study aimed at examining some word formation processes involved in making adjectives in Zamyad-Yasht. What prompted us to select Yasht 19 from the available Yashts in Avesta was its authenticity and antiquity compared to other Yashts. Zamyad-Yasht, the 19th Yasht in Avesta, comprises 96 parts/sections and is about Farr-e Kyani. The results of the study showed that of the word formation processes, including derivation, compounding, derivation and compounding, clipping, conversion, and reduplication, discussed in this study, derivation and compounding were most frequently observed, respectfully

Association of Mortality of Covid-19 with Demographic Characteristics and Clinical Status of the Hospitalized Patients: A Retrospective Cohort Study

Background and Aim: A variety of factors, such as age and underlying diseases, affect the severity of covid-19 and its mortality rate. Identification of these factors is important to manage the disease in vulnerable people. The purpose of this study was to examine the association of outcome of covid-19 with demographic characteristics, underlying diseases, serum biomarkers, and level of care for inpatients. Materials and Methods: This retrospective cohort study was conducted in Sina Hospital in Hamadan in 1400. All adult hospitalized patients with definite diagnosis of COVID-19 were included in the study by convenience sampling method during a three-month period. Demographic and clinical status data were collected using a designed questionnaire. Using SPSS software the data were analyzed by independent t, Mann-Whitney, and multivariate logistic regression analysis tests. Results: A total of 283 hospitalized patients with a mean age of 57.22 years participated in this study, of which 67 (23.7%) died. Among the deceased patients, 92.4% were over 50 years of age which showed a significant difference compared to the deceased patients under 50 years of age (P<0.001). People who died with any documented history of underlying diseases accounted for 83.3% of the deceased patients, and their proportion was statistically significant compared to the patients without any underlying disease (P 0.0005). Prevalence of severe acute respiratory distress syndrome (ARDS) was significantly different in the deceased patients (28.8%) compared to that in the survivors (3.9%) (P<0.001). According to the results of our study age, gender, history of underlying diseases, serum BUN level and severity of acute respiratory distress syndrome are predictors of death in the patients with Covid-19. Conclusion: The findings of this study indicated the need to pay more attention to preventive measures in old people with underlying diseases. It can also help healthcare professionals to consider designing programs for prevention, appropriate care and treatment in relation to the predictors of mortality

Molecular detection of metallo-β-lactamase gene blaVIM-1 in imipenem-resistant Pseudomonas aeruginosa strains isolated from hospitalized patients in the hospitals of Isfahan

Background: Pseudomonas aeruginosa is an opportunistic human pathogen that causes serious problems, especially in people, who have immunodeficiency. In recent times, metallo-β-lactamase (MBLs) resistance in this bacterium has led to some difficulties in treating bacterial infections. The metallo-beta-lactamase family of genes, including blaVIM-1, is being reported with increasing frequency worldwide. The aim of this study is the detection of the metallo-β-lactamase gene blaVIM-1 in imipenem-resistant P. aeruginosa (IRPA) strains isolated from hospitalized patients. Materials and Methods: In this study, 106 P. aeruginosa samples were isolated from various nosocomial infections. The isolates were identified, tested for susceptibility to various antimicrobial agents by the Kirby-Bauer disk diffusion method, and all the imipenem-resistant isolates were screened for the presence of MBLs by using the combined disk (IMP-EDTA). The minimal inhibitory concentration (MIC) of imipenem was determined by E-test on the Mueller-Hinton agar. To detect the blaVIM-1 gene, the isolates were subjected to a polymerase chain reaction (PCR). Results: Of all the P. aeruginosa isolates, 62 (58.5%) were found to be imipenem-resistant P. aeruginosa (MIC ≥32 μg/ml). Twenty-six (42%) of the imipenem-resistant isolates were MBL positive. None of these isolates carried the blaVIM-1 gene using the PCR assay. Conclusion: The results demonstrated the serious therapeutic threat of the MBL-producing P. aeruginosa populations. The rate of imipenem resistance due to MBL was increased dramatically. Early detection and infection-control practices are the best antimicrobial strategies for this organism. None of MBL-producing isolates in this study carry the blaVIM-1 gene; therefore, another gene in the MBL family should be investigated

Detection of blaSPM-1 metallo-β-lactamase gene in Imipenem-resistant Pseudomonas aeruginosa strains isolated from hospitalized patients in Isfahan hospitals

&nbsp;Introduction: Pseudomonas aeruginosa is an opportunistic human pathogen which causes serious problems especially in people who have immunodeficiency. Recently, metallo-β-lactamase (MBLs) resistance in this bacterium has led some difficulties in treating bacterial infections. MBL gene family, including blaSPM-1 caused resistance to beta-lactam antibiotics especially carbapenem (eg, imipenem) and have been reported with high prevalence worldwide. The aim of this study is detection of metallo-β-lactamase gene blaSPM-1 in Imipenem-resistant Pseudomonas aeruginosa strains isolated from hospitalized patients in Isfahan hospitals.&nbsp;Materials and methods:&nbsp;In this study, 252 samples were isolated from various nosocomial infections. These isolates were identified as Pseudomonas aeruginosa by using biochemical tests. Disk diffusion method (Kirby-Bauer) was used to determine the bacterial drug resistance pattern. All imipenem-resistant isolates were screened for the presence of MBLs by using the Combine disk (IMP-EDTA). The minimal inhibitory concentration (MIC) of imipenem was determined by E-test on Mueller-Hinton agar. To detect blaSPM-1 gene, the isolates were subjected to polymerase chain reaction (PCR).&nbsp;Results:&nbsp;In total, 106 isolates of Pseudomonas aeruginosa were collected. Of all isolates, 62 (58.5 %) were found to be imipenem-resistant Pseudomonas aeruginosa.&nbsp;MIC levels in all strains of imipenem-resistant were MIC≥32μg/ml.&nbsp;Twenty-six (48 %) of imipenem-resistant Pseudomonas aeruginosa isolates were MBL positive. None of the isolates carried blaSPM-1 gene by PCR assay.&nbsp;Discussion and conclusion:&nbsp;Results of this study demonstrate that the rate of imipenem resistance due to MBL is increased dramatically. Early detection and infection-control practices are the best antimicrobial strategies for this organism. None of MBL-producing isolates in this study carry blaSPM-1 gene; therefore another gene in MBLs family should be investigated

Major dietary patterns and dietary inflammatory index in relation to dyslipidemia using cross-sectional results from the RaNCD cohort study

Abstract Dyslipidemia can increase the risk of heart attack and stroke due to the restriction of blood flow through the blood vessels. Dietary modification is an appropriate approach to reducing this phenomenon. This cross-sectional study aimed to evaluate major dietary patterns and the dietary inflammatory index (DII) in relation to dyslipidemia. 5954 participants in the Ravansar non-communicable diseases (RaNCD) cohort study were eligible for this study. Dyslipidemia was diagnosed based on the lipid profile under consideration of the RaNCD physician. Dietary patterns were assessed by principal component analysis. The three identified dietary patterns included (1) plant-based pattern; (2) high protein and sugar pattern; and (3) energy-dense dense pattern. DII was also calculated based on the dietary information from a validated semi-quantitative food frequency questionnaire (FFQ). We found that higher adherence to DII was significantly associated with increased odds of dyslipidemia after adjusting for age, sex, and physical activity (OR: 1.24; CI 95% 1.09–1.42). Additionally, higher adherence to the high protein and sugar diet and an energy-dense diet was significantly associated with higher odds for dyslipidemia (OR: 1.31; CI 95% 1.16–1.49) and (OR: 1.28; CI 95% 1.12–1.46). Nevertheless, according to our results, following plant-based diet had no association with dyslipidemia in both crude and adjusted models. Our findings revealed that greater adherence to DII, a high-protein, high-sugar diet, and an energy-dense diet can have undesirable effects on dyslipidemia