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This study aims to assess the effects of central and general adiposity on development of cardiovascular diseases (CVDs) mediated by cardiometabolic risk factors and to analyze their degree of dependency for mediating their effects. To this end, data from the the Tehran Lipid and Glucose Study cohort with 6280 participants were included in this study. The hazard ratios were calculated using a 2-stage regression model in the context of a survival model. Systolic blood pressure (BP), total serum cholesterol, and fasting plasma glucose were designated as mediators. Assessing the interactions revealed that BP was the most important mediator for general ( (HRNIE: 1.11, 95% CI 1.17–1.24) and central obesity (CO) (HRNIE: 1.11, 95% CI 1.07–1.15) with 60% and 36% proportion of the effects mediated in the total population, respectively. The proportion of mediated risk for all three metabolic risk factors was 46% (95% CI 31–75%) for overweight, 66% (45–100%) for general obesity and 52% (39–87%) for central obesity. BP was the most important mediator for overweight and central obesity in men, comprising 29% and 36% of the risk, respectively. The proportion of the risk mediated through all three metabolic risk factors in women was 23% (95% CI 13–50%) for overweight, 36% (21–64%) for general obesity and 52% (39–87%) for central obesity. Based on the results of this study, cardiometabolic mediators have conciliated more than 60% of the adverse effects of high BMI on CVDs in men. Controlling the metabolic risk factors in women does not efficiently contribute to decreasing CVDs as effectively.

Gallstone ileus is rare and inguinal hernias are common causes of intestinal obstruction but combination of them is a very rare cause of intestinal obstruction. It is accepted that in patients with severe comorbidities surgeons can manage inguinal hernias and gallstone conservatively. In this article we report a patient with gallstone and inguinal hernia that managed with conservatively management because of heart failure but admitted with complication of gallstone and hernia and treated successfully.An 80-year-old woman with a history of heart failure and two bouts of acute cholecystitis, who presented with pain and swelling in the inguinal region and obstructive symptoms. And due to the urgent nature of the condition, she underwent surgery.One of the rare complications of gallstones is cholecystoduodenal fistulas, especially in patients whose episodes of cholecystitis are treated medically. Early diagnosis and appropriate surgical management in these circumstances reduce the mortality and morbidity.

Background. Thalassemia is one of the most common genetic hematologic disorders in the world. Despite outstanding achievements in prenatal diagnosis and a decrease in the number of patients, thalassemia is still a significant issue in most parts of the world, especially in the Mediterranean countries. Understanding the factors associated with this condition is crucial to help clinicians and policymakers provides social and medical support for patients to facilitate their lives. This study aims to appraise the quality of life (QoL) and its related paraclinical factors in Iranian transfusion-dependent thalassemia patients. Methods and Materials. This study is a cross-sectional study performed in the thalassemia clinic of Imam-Ali Hospital, Karaj, Iran. The demographic, clinical, and laboratory data of 100 patients with transfusion-dependent thalassemia were recorded. The patients’ QoL was measured by the World Health Organization Quality of Life Instruments Brief (WHOQOL-BREF) version questionnaire. The results were analyzed using SPSS software. Results. This study demonstrated that all four features of life are influenced in transfusion-dependent thalassemia patients. Also, higher educational status and lower serum ferritin levels were associated with better scores in assessing the QoL. On the other hand, an elevated level of AST (aspartate transaminase), ALT (alanine transaminase), and FBS (fasting blood sugar) are associated with lower scores. Conclusion. All features of QoL are correlated to the patients’ laboratory findings. Our data suggest that managing patients’ laboratory indices is attributed to their higher QoL. We also suggest regular screening of patients’ QoL to manage disease complications more efficiently.

Background The mechanisms linking adiposity to associated clinical conditions such as type 2 diabetes, cardiovascular disease, and related metabolic and inflammatory disturbances. are poorly understood.This study aimed to identify sex-specific direct and indirect effects of central and general adiposity on cardiovascular disease, mediated by cardiometabolic risk factors and how much is independent of these factors. Methods We analyzed data from the TLGS cohort study with 6280 participants aged ≥ 30 years, free of cardiovascular disease at baseline with a median follow-up of 13.9 years. The total effects were broken down into natural direct and indirect effects using a 2-stage regression model in the context of the survival model. We also calculated the proportion mediated by systolic blood pressure, total serum cholesterol, and fasting plasma glucose as mediators. Results There was no interaction between BMI and its mediators in the multiplicative scale (P > 0.05 for all). Blood pressure was the most important mediator for general (HRNIE: 1.11, 95% CI:1.17–1.24) and central obesity (HRNIE: 1.11, 95% CI:1.07–1.15) with proportion mediated of 60% and 36% respectively in the total population. The percentage mediated through all three metabolic risk factors together was 46% (95% confidence interval = 31%-75%) for overweight, 66% (45%-100%) for general obesity and 52% (39%-87%) for central obesity. Blood pressure was the most important mediator for overweight and central adiposity in male population with 29% and 36% proportion mediated respectively while in female population percentage mediated through all three metabolic risk factors together was 23% (95% confidence interval = 13%-50%) for overweight, 36% (21%-64%) for general obesity and 52% (39%-87%) for central obesity. Conclusions Metabolic mediators explain more than 60% of the adverse effects of high BMI on CVD in the male population. Also, managing these metabolic mediators in women does not effectively contribute to reducing CVD risks without decreasing weight.

An outbreak of pneumonia, caused by a novel coronavirus (COVID-19) was Identified in China in Dec 2019. This virus expanded worldwide, causing global concern. Clinical, laboratory and imaging features of this infection are characterized in some observational studies. We undertook a systematic review and meta-analysis to assess the frequency of clinical, laboratory, and CT features in COVID-19 patients.We did a systematic review and meta-analysis using three databases to identify clinical, laboratory, and CT features of rRT-PCR confirmed cases of COVID-19. Data for 3420 patients from 30 observational studies were included.Overall, the results showed that fever (84.2%, 95%CI 82.6-85.7), cough (62%, 95%CI 60-64), and fatigue (39.4%, 95%CI 37.2-41.6%) were the most prevalent symptoms in COVID-19 patients. Increased CRP level, decreased lymphocyte count, and increased D-dimer level were the most common laboratory findings. Among COVID-19 patients, 92% had a positive CT finding, most prevalently GGO (60%, 95%CI 58-62) and peripheral distribution (64%, 95%CI 60-69).These results demonstrate the clinical, paraclinical, and imaging features of COIVD-19.