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Background and purpose: Cardiovascular diseases are the most important diseases of the elderly, and recently the effect of triglyceride glucose (TYG) index as one of the indicators of insulin resistance in type 2 diabetes and coronary artery disease has attracted the attention of researchers. Previous research has shown a link between insulin resistance and coronary artery calcification. Since triglyceride glucose index (TyG) is an index that is easily available, this study aimed to investigate the relationship between triglyceride index and fasting blood sugar and coronary heart disease and diabetes in the elderly of Amirkola. Materials and methods: This cross-sectional study was conducted on the elderly participating in the second phase of the Amirkola Health and Aging Cohort Study (AHAP). The elderly were divided into two groups of 200 people, the first group was diabetics with cardiovascular disease and the second group was diabetic elderly without cardiovascular disease. Patient information including age, sex, body mass index, diabetes, coronary artery disease, history of dyslipidemia, medications, triglycerides, fasting blood sugar, smoking habits, systolic and diastolic blood pressure, cholesterol, creatinine, physical activity, and HbA1c were collected in a checklist. The TYG index was calculated based on the LN formula [fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2]. Ultimately, SPSS version 25 software was utilized to describe the data using mean, standard deviation, and percentage. The qualitative variables were compared with the coronary artery disease using the chi-square test, while the quantitative variables were compared using the independent t-test in univariate analysis. Furthermore, the process of adjusting for confounding variables was carried out by using multivariate logistic regression. Results: In this study, 400 diabetic elderly participants were examined based on the relationship between triglyceride glucose index and coronary artery disease. The average age of the elderly with coronary artery disease was 70.46±6.10 and the elderly without coronary artery disease was 70.50±6.49 years. Triglyceride glucose index in diabetic elderly with and without coronary artery disease was 9.3±0.68 and 9.30±0.65, respectively, which was not statistically significant (P=0.92). Mean creatinine (P=0.004), number of comorbidities (P

Background: Vitamin D is a modifiable risk factor in cancer and prostate diseases. In this study, we investigate the relationship between vitamin D and serum PSA in elderly men of Amirkola City. Methods: The current cross-sectional descriptive study was conducted on elderly men participating in the cohort study in Amirkola. Demographic information including age, sex, marital status and occupation were recorded and blood samples (5 cc of blood) were taken to measure PSA and vitamin D. A p -value less than 0.05 is statistically significant. Results: After applying the inclusion and exclusion criteria, 837 elderly men with mean age of 69.99 ± 7.72 years were included in the study. In terms of marital status, 779 (93.1%) were married and 59 (6.9%) were single. In the study of employment status, 476 (56.9%) self-employed, 331 (439.5%) retired, 8 (1.0 %) housewives, 14 (1.7%) unemployed and 8 (1.0 %) They were in an unknown situation. The mean level of vitamin D was 31.94 ± 28.57 ng / mL and the mean level of PSA was 1.94 ± 3.28 ng / dL. No significant relationship was found between vitamin D level and serum PSA in Pearson Correlation test (P = 0.16). Among the other variables studied, only age was related to PSA levels and PSA level increased with age (P = 0.001). Conclusion: No significant relationship was found between PSA serum level and vitamin D level, but the existence of vitamin D deficiency in most of the elderly studied needs attention.

Background: Noninvasive ventilation (NIV) has been used as one of the most promising methods to treat hypoxic respiratory failure in COVID-19. Methods: In this study, the clinical outcomes of 80 patients with acute respiratory failure caused by COVID-19 were evaluated. The disease was confirmed in two methods: clinical and radiographic confirmation of disease in patients with an acute respiratory infection (highly suspected) or in some cases with a positive PCR test. The rate of discharge from the ICU without the need for intubation was evaluated as the primary outcome and based on that, the patients were divided into two groups: NIV failure and NIV success. Mortality rate, length of stay in ICU, frequency of intubated patients and laboratory factors of patients as secondary outcomes in two groups were compared. Results: Regarding the outcome of death and discharge, there was a statistically significant difference between the two groups. Therefore, all patients with corona who were admitted to ICU and received NIV and were intubated due to non-responsiveness to NIV died and the patients were discharged from the hospital without intubation. All the patients investigated in this study, had received antiviral, antibiotic, and glucocorticoid treatment during hospitalization. In this study, the patients who were in the NIV success group and were not intubated had a lower mean age compared to the group without NIV success (54 vs. 67 years, respectively). The number of white blood cells in the NIV success group was 3945.28±10011.21 and in the group without NIV success was 9242.38±17296.16, which was statistically significant (P=0.004). The number of blood neutrophils in the successful and unsuccessful NIV groups was 12.19±83.04 and 4.31±89.49, respectively (P=0.034). The mean APACHEII score in patients in the NIV success group (11.07±5.05) was significantly lower than the group without NIV success (20.16±4.96). Conclusion: Mortality was higher in the intubated group than in the NIV group. The combination of APACHEII score and respiratory rate one hour after receiving NIV can predict success with NIV.

Background and purpose: Population aging is a global phenomenon and increase in the number of people over 60 yeas of age proves that the world is aging. An important component of successful aging is maintaining muscle mass and its function throughout life. This study investigated the relationship between vitamin D serum level and muscle strength in the elderly as one of the important components of successful aging. Materials and methods: In this cross-sectional study, out of 1,616 people who participated in the Amirkla Elderly Cohort, 720 people were randomly selected by considering eligibility criteria. The participants were divided according to their Vitamin D serum concentrations: Vitamin D deficiency (20ng/ml>), inadequate (30ng/ml>Vitamin D>20ng/ml), and sufficient (30ng/ml

Abstract Background Given the importance of chest computed tomography (CT) to differentiate congestion from COVID-19 pneumonia, and considering the association of chest CT findings with cardiac biomarkers in patients with concomitant COVID-19 and heart failure, this study was conducted to identify the correlation between plasma NT-proBNP level and radiographic features of congestion in patients with COVID-19. This retrospective cohort research was carried out on adult hospitalized patients with COVID-19 and the plasma concentration of NT-proBNP was measured. The most important findings in chest CT have been considered to differentiate COVID-19 pneumonia from congestion. The study population was divided into two groups based on the presence of these imaging characteristics. Results Totally, 180 patients with a mean age of 59.6 ± 14.6 years were included in the research. The radiographic findings related to congestion have been found in chest CT of 107 (59.4%) patients. Mean plasma concentration of NT-proBNP in patients with and without radiographic features of congestion was 9886.5 ± 12,676 and 2079.9 ± 4209.3 pg/mL, respectively (p

Abstract Background Breast cancer (BC) is the most common malignancy in women. Identifying and avoiding the preventable risk factors of BC reduces its occurrence effectively. So, this study aimed to assess BC’s risk factors and risk perception status in Babol, Northern Iran. Methods This cross-sectional study was conducted on 400 women aged 18 to 70 in Babol, Northern Iran. According to the eligibility criteria, the selected participants completed the demographic characteristics and researcher-made valid and reliable questionnaires. The statistical software was SPSS20. Results The significant risk factors related to BC were old age (60 years old and more) (30.2%), obesity (25.8%), history of radiation (10%), and familial history of BC (9.5%), respectively (P

BACKGROUND: Students, as a representative of young adults, are at risk for engagement in unhealthy lifestyle behaviors such as unhealthy eating, unhealthy relationships, and drug abuse. Health-promoting lifestyle (HPL) largely depends on adequate knowledge of healthy behaviors and hence, education is a strategy with potential positive effects on lifestyle. This study aimed at evaluating the effects of web-based education (WBE) on HPL among first-year medical sciences students. MATERIALS AND METHODS: This quasi-experimental study was conducted in 2020 with a single-group pretest-posttest design. Participants were 185 first-year bachelor’s and doctoral medical sciences students selected from Babol University of Medical Sciences, Babol, Iran, through multistage sampling. Study intervention was a three-week web-based educational program on HPL. Educational videos about the different components of HPL were sent to participants through WhatsApp. Data were collected before, one month after, and three months after the study intervention through the Health-Promoting Lifestyle Profile (HPLP2) and the General Health Questionnaire (GHQ). The STATA software (v. 16.0) was used for data analysis. RESULTS: Among 185 participants, 154 (83.69%) participants completed the study. The mean scores of HPL and its health responsibility and stress management subscales significantly increased by 4.58 (95% CI: 0.12, 9.04), 1.77 (95% CI: 0.39, 3.15), and 0.71 (95% CI: 0.13, 1.26), respectively. However, the mean scores of the nutrition, interpersonal relations, physical activity, and self-actualization subscales of HPL and the mean score of general health did not significantly change (P > 0.05). CONCLUSION: WBE has significant positive effects on HPL and its health responsibility and stress management subscales. Therefore, WBE through social media can be used to improve HPL among young adults, particularly students.

Background: The Early Arthritis for Psoriatic Patients (EARP) questionnaire is a fast and simple way to screen psoriatic arthritis. This study was carried out to investigate the diagnostic accuracy of the Persian version of the Early Arthritis for Psoriatic Patients (P-EARP) questionnaire. Methods: A total of 100 psoriasis patients responded to the questionnaire after the translation procedure (translation, back translation). After determining the validity of the questionnaire, the diagnostic accuracy of the P-EARP questionnaire was assessed using the ROC curve (receiver operating characteristic curve). Internal and external reliability of the questionnaire were also evaluated by statistical tests. Results: In assessing the reliability of the questionnaire using test-retest, correlation coefficient (r=0.994, p

Background: Sporadic lymphangioleiomyomatosis (S-LAM) is a rare disease that generally affects young women and involves the abnormal proliferation of smooth muscle cells (LAM cells) in the lungs (pulmonary LAM). There are two types of LAM, sporadic and LAM with tuberous sclerosis, which is an autosomal dominant genetic disease caused by mutations in the Tsc1 and Tsc2 genes. The most common manifestation of this disease is pneumothorax due to cyst rupture. Median transplant-free survival for pulmonary LAM is 23 years from diagnosis. Factors associated with a poor prognosis are often those associated with a more rapid decline in lung function. Case Presentation: The patient was a 24-year-old woman who presented with pneumothorax and multiple bullae in both lungs. The patient had no family history of respiratory disease, and the patient herself had no symptoms other than mild shortness of breath following activity from a year ago. A lung CT scan was performed for the patient and multiple bullae were evident in both lungs, which confirmed the diagnosis. There was no evidence of involvement of other organs but the lung. For the patient in the ICU with the diagnosis of left pneumothorax, a chest tube was inserted and she underwent mechanical ventilation. Finally, after 24 days of hospitalization, oxygen therapy of the patient was performed with a normal mask, and she underwent left lung pleurodesis with talcum powder, and a few days later, right lung pleurodesis was performed on the patient. On the 36th day of hospitalization, her general condition improved and she was discharged from the ICU. The patient was discharged in good general condition and had no problem on her four months follow-up. Conclusion: Fortunately, with the diagnosis of LAM for the patient according to the CT scan of the patient's lung, she was treated with insertion of a chest tube and by performing pleurodesis, the recurrence of pneumothorax was prevented. In a young woman with spontaneous pneumothorax, sporadic LAM is one of the differential diagnoses.

Background and purpose: Appropriate drug regimen during colonoscopy is one of the matters of concern in anesthesia. This study was conducted to compare the efficacy of propofol-ketamine combination and propofol-fentanyl in colonoscopy. Materials and methods: In a single-blind randomized clinical trial, 200 patients aged 18-60 years candidate for colonoscopy, were randomly allocated into two groups to receive either fentanyl-propofol (PF) or ketamine-propofol (PK) using block randomization. Recovery time (end of injection until Steward Score was 6) as the primary outcome and vital signs, complications, total dose of propofol, and satisfaction of the doctor performing the colonoscopy as secondary consequence were compared between the two groups. Results: Recovery time was 2.97 ± 0.89 min in the fentanyl-propofol group and 8.84 ± 1.73 min in ketamine-propofol group (P

Background & Objective: The assessment of the interest of medical students in continuing their studies in specialized fields and the factors affecting it can play a strategic role in macro educational planning. Therefore, the present study aimed to assess the level of academic interest and the factors affecting the choice of specialty in medical students of Babol University of Medical Sciences. Materials & Methods: In this applied cross-sectional study, the study population included incoming medical students from 2009 to 2017 in clinical preparation, stager, and internship. The participants were selected by the convening sampling, and the research tool was a researcher-made questionnaire. Data were collected and entered into SPSS software (version 22) and analyzed by related tests at a significance level of p-value ≤ 0.05. Results: The mean age of students was 23.02±1.65 years, and124 (61/4%) students were female. Moreover, 96.6% of students wanted to continue their studies in residency. Social status in 142 (70.3%) students and lack of free time in 97 (48%) students, respectively, were the most important positive and negative influential factors in the selection of medicine as the field of study. Three fields of cardiology (n=9; 145.1%), radiology 84 (n=84; 41.6%) and ophthalmology (n=82; 40.6%) were the first three priorities. No statistically significant difference was observed in gender in any of the specialties, except urology (P=0.008). Conclusion: Interest, social status, income, years of study, and hospital attendance status were the factors affecting the choice of residency among medical students.

Background: Information on the coronavirus infection 2019 (COVID-19) which can clinically range from asymptomatic infection to severe pneumonia, in transplant recipients is still low. Infections are a major cause of death in kidney transplant recipients, and kidney transplant recipients, like other organ recipients, appear to be more vulnerable to a variety of infections due to comorbidities and immunosuppressive drugs that predispose them to infection. Case presentation: In this study, we reviewed 10 transplant recipients with a mean age of 50.3±11.25 years who were admitted to Ayatollah Rouhani Hospital in Babol due to COVID-19 From April 2019 to September 2019. Four patients were female and six ones were male. Fever (100%) and cough (60%) were the most common symptoms in patients. All patients used standard immunosuppressive drugs (tacrolimus, corticosteroids, mycophenolate, and cyclosporine). The mean level of oxygen saturation at the time of admission in these patients was 87.9±11.3 and in two patients with death outcomes of 57% and 95%, it was at the beginning of hospitalization. The mean leukocytes of patients at the beginning of hospitalization was10470±5784.08 per ml and the mean lymphocytes of these patients were 1081.5±516.05. In the studied patients, the mean of previous years of transplantation was 8/05±7.13 and two patients died 20 years and 5 years after their kidney transplantation. Two patients (20%), aged 57 and 50 years, died from progressive respiratory symptoms and the other eight patients recovered and were discharged from the hospital. We reported COVID-19 infection in ten kidney transplant recipients with different clinical outcomes and periods, which may be a reference for the management of COVID-19 in such patients. Conclusion: It seems that more information is needed to better understand the effect of anti-transplant immunosuppressive therapy on the outcome of COVID-19 infection in kidney transplant recipients. Long-term follow-up studies and more cases are needed to clarify the diagnosis, outcome, and treatment options for COVID-19 in these patients.

Background. Achieving a suitable medical laboratory index is very important for the prediction of clinical outcome of COVID-19 patients hospitalized to the intensive care unit (ICU). The correlation between neutrophil-to-lymphocyte ratio (NLR) and unfavorable outcome of COVID-19 patients hospitalized to ICU was the aim of this study. Methods. We evaluated a cross-sectional study of 312 COVID-19 patients who were hospitalized to the ICU (confirmed by PCR and CT-Scan), in Babol city, Mazandaran province. WBC, RBC, lymphocyte, neutrophil, monocyte, platelet count, NLR, C-reactive protein (CRP), ESR, MCV, MHC, and other factors were evaluated. Results. Our findings indicated that all patients aged 56 to 69 years with COVID-19 had a significant difference (P

Background & aim: Iranian policymakers have recently shifted away from a birth control towards a pro-fertility policies. In this regard, it is indispensable to recognize the determinants of childbearing willingness to evaluate the influence of these policies on certain target groups. With this background in mind, the present study aimed to find determinants of childbearing willingness in employed women. Methods: In this cross-sectional study, 140 married females, holding non-professional job positions in Iran University of Medical Sciences (IUMS), Tehran, Iran, completed a self-administered questionnaire about demographic characteristics, actual and ideal number of children, own and spouse’s willingness to have another child, in addition to perceived incentives and barriers of childbearing. Chi-square test and logistic regression analysis were applied for data analysis. Results: The mean age of participants was reported as 39.48±6.915. The actual and ideal number of participants’ children were obtained at 1.32±0.77 and 2.3±1.06, respectively (P-value

Background: Botulism is mostly caused by Clostridium botulinum neurotoxin which has been described as a bilateral symmetric descending flaccid paralysis. Preventing and responding to botulism outbreaks is a public health emergency. In this study, the disease is reported in a family. Methods: In a case series study, during an outbreak, four members of a family with symptoms including paralysis, ptosis, blurred vision, diplopia, weakness, dysphagia, dry mouth, respiratory problems, vertigo, and lethargy, referred to Loghman Hospital of Tehran. Among the patients was an elderly woman and a pregnant woman. All clinical signs and symptoms of the patients were recorded daily in a researcher-made questionnaire from 27 August to 3 September 2018. At the time of admission, vital signs (pulse rate, respiration rate, and body temperature) of patients were stable and within normal limits. Following clinical suspicion of food-borne botulism in these patients, samples of the first two patients, including serum, stool, gastric secretions, and homemade whey were sent to the Botulism Laboratory of Microbiology Department of Pasteur Institute of Iran for the mouse bioassay. Results: Type A neurotoxin was detected in homemade whey after the mouse bioassay. Therefore, foodborne botulism was confirmed in patients with laboratory results. Patients included two men and two women with a mean age of 52.7 years old. The length of hospitalized days was between 2 and 6 days. Two of the patients were admitted to the intensive care unit (ICU). Patients under study were fully recovered with timely diagnosis of the disease, treatment with antitoxin, and supportive care. Conclusion: When conscious patients referred to the hospital with symptoms of paralysis, foodborne botulism is an important differential diagnosis. On-time diagnosis and antitoxin treatment can prevent serious complications.

Background: Foodborne botulism is a fatal paralytic illness caused mainly by the neurotoxin produced by an anaerobic bacterium called Clostridium botulinum. In this study, the frequency of foodborne botulism in patients referred to a hospital in Iran has been reviewed for ten years. Methods: In this routine database study, medical records of patients with foodborne botulism referred to Loghman Hospital in Tehran City, Iran, from March 20, 2008, to March 20, 2019, were reviewed. Information on variables of age, sex, place of residence, food consumed, clinical symptoms of patients (such as dysphagia, nausea, vomiting, ataxia, etc.), toxin type, and length of hospitalization were collected with a researcher-made questionnaire. Finally, the collected data were analyzed in SPSS-24 with descriptive and analytical statistical tests. Results: In this study, 61 suspected botulism patients were clinically diagnosed in Loghman Hospital, of whom 55 patients were clinically suspected of foodborne botulism, 5 patients had iatrogenic botulism, and 1 patient had infant botulism. Of these 55 patients with the clinical diagnosis of foodborne botulism, 19 patients were confirmed by laboratory examinations, and 2 patients died. Sixteen patients confirmed by laboratory had neurotoxin botulinum type A. The mean age of the patients was 36.9 years with a standard deviation of 18.6 years. About 54.5% of the patients were male and 45.5% female. Weaknesses (58.2%), ptosis (droopy eyelid) (56.4%), and diplopia (double vision) (52.7%) were the common clinical symptoms of the patients under study. Canned foods and dairy products were the main foods consumed by the patients. The duration of admission time ranged between 1 and 41 days, with an average of 7.7 days. About 23.64% of patients were admitted to the intensive care unit. Conclusion: The prevalence of foodborne botulism is rare compared with other food poisonings but is still a major public health problem due to the consumption of traditional food products and unboiled canned foods in Iran.