Risk factors of developing critical conditions in Iranian patients with COVID-19

COVID-19 due to novel Coronavirus was first reported in Wuhan, China. Nowadays, the Islamic Republic of Iran stands among countries with high COVID-19 prevalence and high burden of disease. Since the medical resources are limited, we aimed to identify the risk factors for patients developing critical conditions. This can help to improve resource management and treatment outcomes. In this retrospective study, we included 12,677 patients who were from 26 hospitals, supervised by Tehran University of Medical Sciences with signs and symptoms of COVID-19, until April 12. University integrated IT system was adopted to collect the data. We performed Logistic regression to evaluate the association between death in COVID-19 positive patients and other variables. Cough, respiratory distress and fever were the most common symptoms in our patients, respectively. Cancer, chronic lung diseases and chronic neurologic diseases were the strongest risk factors for death in COVID-19 patients. © 202

Phylogenetic Distribution of Intron Positions in Alpha-Amylase Genes of Bilateria Suggests Numerous Gains and Losses

Most eukaryotes have at least some genes interrupted by introns. While it is well accepted that introns were already present at moderate density in the last eukaryote common ancestor, the conspicuous diversity of intron density among genomes suggests a complex evolutionary history, with marked differences between phyla. The question of the rates of intron gains and loss in the course of evolution and factors influencing them remains controversial. We have investigated a single gene family, alpha-amylase, in 55 species covering a variety of animal phyla. Comparison of intron positions across phyla suggests a complex history, with a likely ancestral intronless gene undergoing frequent intron loss and gain, leading to extant intron/exon structures that are highly variable, even among species from the same phylum. Because introns are known to play no regulatory role in this gene and there is no alternative splicing, the structural differences may be interpreted more easily: intron positions, sizes, losses or gains may be more likely related to factors linked to splicing mechanisms and requirements, and to recognition of introns and exons, or to more extrinsic factors, such as life cycle and population size. We have shown that intron losses outnumbered gains in recent periods, but that “resets” of intron positions occurred at the origin of several phyla, including vertebrates. Rates of gain and loss appear to be positively correlated. No phase preference was found. We also found evidence for parallel gains and for intron sliding. Presence of introns at given positions was correlated to a strong protosplice consensus sequence AG/G, which was much weaker in the absence of intron. In contrast, recent intron insertions were not associated with a specific sequence. In animal Amy genes, population size and generation time seem to have played only minor roles in shaping gene structures

Serum procalcitonin level in infectious and non- infectious systemic inflammatory response syndrome: a three- year study

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Sepsis is the leading cause of hospital admission and mortality. One marker for differentiation between infectious and non-infectious diseases is serum procalcitonin (PCT) level. The goal of this study was evaluation of serum procalcitonin level for differentiation among infectious & non infectious systemic inflammatory response syndrome (SIRS)."n"nMethods: In a cross sectional study 263 patients with probable symptoms of sepsis that admitted to emergency department of Imam Khomeini Hospital Complex in Tehran, Iran, between 2006 and 2008, were evaluated for serum procalcitonin level by semi quantitative method. The clinical findings, demographic and laboratory data were identified by reviewing the medical notes."n"nResults: A total of 263 patients enrolled in the study. Mean age in study patients was 46.9 year (±20.7) and most of the patients were male (65.8%). In 104 patients (39.5%) serum procalcitonin level was less than 0.5 (ng/ml), in 49 patients (18.6%) was between 0.5 and 2 (ng/ml), in 74 patients (28.1%) was between 2 and 10 (ng/ml) and in 36 patients (13.8%) was more than 10 (ng/ml). Sixty three patients (60.6%) with PCT<0.5ng/ml, had non-infectious SIRS, while all patients with PCT≥10ng/ml, had infectious SIRS. Procalcitonin level in patients with infectious SIRS was significantly more than patients with non-infectious SIRS (p<0.0001). Sensitivity of test for cut off point of 0.5, 2 and 10 (ng/ml) were 89.2%, 67.1% and 22.8% respectively, and its specificity for cut off points of 0.5, two and 10 were 82.9%, 96.2% and 100% respectively."n"nConclusions: Procalcitonin level in combination with an appropriate clinical assessment can help us in beginning of antibiotic therapy timely and improve diagnostic and prognostic evaluation of patients with sepsis. "n&nbsp

Prevalence of positive autoimmune biomarkers in the brucellosis patients

Brucellosis is a chronic infectious disease with articular involvement. Discrimination between brucellosis and rheumatologic disorders is difficult in regions endemic for brucellosis. There are few studies about the rate of positive autoantibodies as rheumatologic biomarkers in brucellosis, and the prevalence is variable. In this study, the rheumatologic tests were studied in brucellosis patients. This cross sectional study was performed in two teaching hospitals in Tehran, Iran. Forty-nine patients with brucella infection and 42 healthy participants were enrolled in this study. Brucellosis was diagnosed on the basis of the clinical symptoms and positive serology for brucellosis. Rheumatic factor (RF) and antinuclear antibodies (ANA) were evaluated in all patients. Cyclic citrullinated peptides antibody (ACPA) and anti-double strand DNA (anti-dsDNA) were checked in all patients and control groups. Out of 49 patients, 15 (30.6 ) were RF positive and 4 (8.2 ) were ANA positive. Anti-dsDNA was concurrently positive with ANA in 1 patient (2 ) but ACPA titer was positive in 8 patients (16.3 ). None of the patients with positive autoantibody biomarkers fulfilled the criteria for rheumatologic disorders. The rate of positive RF in healthy people was significantly lower than patient group (2.4 vs. 30.6 ), but the positiveness rate of other biomarkers did not have significant difference in two groups. Sixty percent of the patients with positive RF and 75 with positive ACPA had skeletal involvement (P < 0.05). Autoantibody biomarkers can be positive in brucellosis. Rheumatologists should be aware of brucellosis in patients with musculoskeletal involvement and positive autoantibody biomarkers in endemic regions. © 2016, International League of Associations for Rheumatology (ILAR)

Chronic Meningitis: A study on epidemiological and clinical findings, treatment results and prognosis of 97 patients

Central nervous system’s disorders including chronic meningitis (CM) have considerable mortality and irreversible complications, and diagnosis and treatment of CM is difficult. In this retrospective study we reviwed epidemiological and clinical findings, treatment results and prognostic factors of 97 patients with CM admitted in Imam Khomeini hospital for the last 10 years. Important etiological factors in this study included: Mycobacterium Tuberculousis (8.2%) Brucellae SP (5.2%), malignancies (1%) and unknown (85.5%); the sexual ratio was 2:1 (Male/Female) and the most common clinical manifestations were: fever, headache, cranial and motor neuron involvement, seizure and ataxia. Treatment regimens used included antituberculosis agents with or witout corticosteroids, in which the prognosis was better in patients who had been treated with antituberculosis agents alone. The mortality rate was 22.7%, which was in accordance with other studies. We suggest using of antituberculosis treatment alone in comparison with antituberculosis and corticosteroid. Last but not least a double blind randomized clinical trial for a longer period is needed to further substantiate the results of this study

Sputum Conversion Among Patients With Smear Positive Pulmonary Tuberculosis

Introduction: In the patients with smear-positive pulmonary tuberculosis (TB) bacteriologic assessment of sputum for detection of acid bacilli (AFB) Has essential role. This evaluation is accomplished by direct sputum smear &amp;amp; sputum culture. These examinations must be done in regular and preferably monthly after beginning of treatment. These tests have two important aims, including, determining of treatment efficacy &amp;amp; duration of isolation.&quot;nMethods and Materials: Most of the studies have that classic six month regimen led to sputum smear conversion &amp;amp; negative sputum culture in 85% of patient. This treatment regimen has two phases, including, attack phase and maintenance phase. In the attack phase we use four drugs, including, Isoniazid (INH), Rifampin (RMP), Pyrazinamide (PZA) and Ethambutol (EMB) for the first 2 months and if necessary until the end of third month. In the maintenance phase we use INH and Rif for the remaining of treatment course. The main objectives of this study were to determine the time needed for smear conversion and assessment of probable factors which may influence the smear conversion until 4 months after beginning of therapy. The factors that were assessed, were, Age, nationality, sex, clinical symptoms, underlying diseases, chest radiography (number of cavities), smoking, drug abuse and concentration of AF13 in the sputum Generally, we did this cross sectional study on the patient&apos;s records, who had been observed in Imam Khomeni Hospital, west health service center and masih daneshvary hospital between.&quot;nResults: This study showed that from totally 218 patients, 138(74.6%) patients had sputum conversion at the first 2 months of treatment and until the end of 3rd &amp;amp; 4th month this rate reached to 83.3% respectively. So in the end of fourth month only 32(14.7%) patients did not show sputum smear conversion. On the other hand this study showed that two factors including presence of cavities in chest radiography &amp;amp; concentration of AFB in the sputum are influencing this rate strongly.&quot;nConclusion: Role of other factors such as age, nationality , Smoking, diabetes mellitus and weigh loss are controversial and another studies are necessary for confirming their roles. Other factors including sex, clinical symptoms has not been show to be important. Some factors such as drug abuse and immunosuppresive therapy has not been assessed in this study, because number of cases were not enough for statistical analysis

Study of 17 patients with Tuberculosis and HIV infection

Tuberculosis is an important opportunistic disease among HIV- infected persons worldwide; from March 1999 to Feburery 2001 we had seventeen patients with HIV-infection and tuberculosis. Here we are presenting the clinical manifestations, diagnosis, treatment and outcome of them. All of them were male, 11 patients had pulmonary and 5 patients had extrapulmonary (pleural effusion 1, hepatic granulomatosis 1, lymphadenopathy 3), one patient had pulmonary and polyserositis tuberculosis. Tuberculin skin test was positive in 6 paitents and only six patients had CD4 cell count at the beginning of their diseas, thirteen patients had positive smear for acid fast bacilli and four paitents had pathology compatible with tuberculosis (caseating granulomatous). Three patients were hemophiliac, nine patients were injecting drug users, fourteen paitents were treated with 6 months regimens and five patients died. Six patients had the scar of BCG vaccination and others did not know anyting about it

A Survey On Gastrointestinal And Hepatic Manifestations Of Brucellosis Imam Hospital (1995-2001)

Brucellosis is a zoonotic disease of worldwide distribution. Despite its control in many developing countries the disease remains endemic in Iran. The symptoms, signs and laboratory results are variable and nonspecific. This case series study was conducted to determine the liver complications of Brucellosis in Iran&quot;nMaterials and Methods: We studied 188 patients (108 males and 80 females) with Brucellosis, fulfilled the diagnostic criteria, aged 1-79 years (mean 34.8 years) were registered in Imam Khomeini Hospital, a referral center in Tehran, during the six years (1995-2001).&quot;nResults: Thirty-four of 188 cases (18.08 percent) had elevated liver enzyme (elevated SGOT only, 6 patients; elevated SGPT only 1 patient; elevation of both transaminases, 27 patients). The prominent symptoms included anorexia (74 cases), weight loss (62 cases), right upper quadrant pain (32 cases), epigastric pain (25 cases) and nausea and vomiting (23 cases). Among the gastrointestinal signs were found in these patients, hepatomegaly was seen in 28 patients. Jaundice and ascitis were present in only 7 and 3 patients, respectively. Other laboratory results showed elevated alkaline phosphatase in 28 cases and abnormal bilirubin in 10 cases. Fifty-seven patients had a focal illness, representing 30.32 percent of all patients. Osteoarticular complications were the most frequent focal forms, being present in 34 cases. Twelve male patients had genitourinary Brucellosis, representing 10.53 percent of focal forms. Also, 5 patients had neurologic complications.&quot;nConclusion: In conclusion liver involvement is frequent in Brucellosis, although the rate of this complication in our study was lower than other studies. So, in patients with evidence of overt clinical or laboratory findings compatible with liver disturbance etiologies other than brucellosis should be considered in Iran.&quot;n&quot;n&quot;n&amp;nbsp

Prevalence of oral lichen planus in HCV infected patients: the effective factors

&quot;nBackground: Hepatitis C is a major cause of chronic liver disease and hepatocellular carcinoma. Hepatitis C infection also has extrahepatic manifestations, including cryoglobulinemia and lichen planus. Lichen planus is a relatively common mucocutaneous disorder, and, due to its chronic pattern and increased incidence of malignancy, diagnosis and treatment of this disease are very important. The aim of the present study was to investigate the prevalence of oral lichen planus in HCV-infected patients. &quot;nMethods: In this cross sectional- descriptive study, the prevalence of oral lichen planus was evaluated by means of observation, clinical examination, questionnaire and evaluation of the medical records of 150 patients referred to the hepatitis clinic, gastrointentrology and infectious disease wards of Imam Khomeini Hospital and the Iran Blood Transfusion Organization, Tehran, Iran. We used a sequential method for sampling. Data were analyzed using statistical software (SPSS ver. 11) and the chi-square test. &quot;nResults: From a total 150 patients, 133 were male and 17 female. Six cases (4%) had oral lichen planus. All patients with oral lichen planus were male and the buccal mucosa was the most common site. &quot;nConclusions: According to this study, the prevalence of oral lichen planus in patients afflicted with HCV is higher than in the normal population. We should pay more attention to oral lichen planus as one of the extrahepatic manifestations of hepatitis C