alireza jafarinezhad

Sleep disorders frequently affect end-stage renal disease patients on dialysis. However, the relationship between sleep quality and residual kidney function is still unclear. Therefore, this study aimed to investigate this relationship.

In this analytical cross-sectional study, 225 patients who were referred to dialysis centers were studied, and based on renal function, they were classified into two groups with and without residual kidney function. The study employed the Pittsburgh Sleep Quality Index questionnaire to evaluate sleep quality. Multiple linear regression was utilized to determine the factors affecting sleep quality with a significance level consideration at p<0.05.

The mean age of patients was 58.23 ± 13.50 years. 58.7% of patients were males. The problem of serious and very serious sleep in the Sleep latency and sleep duration has been more than other components. 72% of hemodialysis patients had poor sleep quality. In the multiple linear regression model, age (β = 0.442, 95% CI: 0.096, 0.788), sex (β = -0.847, 95% CI: -1.641, -0.054), Body mass index (β = 0.153, 95% CI: 0.058, 0.249) and dialysis duration (β = 0.097, 95% CI: 0.002, 0.192) were independently and significantly associated with sleep quality score. However, there was no statistically significant relationship between sleep quality and residual kidney function.

In conclusion, poor sleep quality is very common in patients undergoing hemodialysis. Therefore, sleep disorders in hemodialysis patients should be considered as one of the most challenging problems by healthcare providers, and early diagnosis and intervention are essential to improve sleep quality.

 The COVID-19 pandemic has been a significant concern for the global health community since its onset. This study aimed to evaluate lung function tests in the follow-up of COVID-19 patients discharged from Razi Hospital in Rasht, Iran, in 2020.

 This cross-sectional study evaluated lung functional tests, including spirometry and the six-minute walking test (6MWT), in the follow-up of 239 hospitalized COVID-19 cases. All demographical and clinical data, along with the lung performance test results of the patients, were recorded, and statistical data were analyzed using SPSS, version 24.

 The mean age of the patients was 51.69±13.98 years, and most of them were females. About 60.25% of patients had underlying diseases. The frequency of positive 6 MWT tests during the first three, six, and nine months after discharge was 7.96%, 8.70%, and 14.29%, respectively. In the first trimester after discharge, the 6MWT test was more positive among females. In addition, forced expiratory volume (FEV1)/forced vital capacity (FVC) showed a significant positive relationship with diastolic blood pressure (DBP) and heart rate (HR). After six months, positive 6MWT results were significantly associated with older ages and underlying diseases. The amount of FVC was positively associated with DBP, distance traveled in the 6MWT test, and HR, but it was negatively related to age.

 The findings revealed that older age, female gender, and underlying diseases were associated with positive 6MWT results, decreased pulmonary function, and higher DBP and HR.

The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments.

This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran.

This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05.

The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001).

The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran.

Evidence of increased serum uric acid (UA) levels during asthma exacerbations is still unclear. High levels of UA may lead to increased inflammation; in this regard, we aimed to investigate the level of UA and associated factors in patients with exacerbation of asthma attacks and those with controlled asthma.

In this study, demographical and clinical data from 300 patients (150 outpatients and 150 hospitalized patients) with asthma who were referred to Razi Hospital, Rasht, Iran, from August 2018 to March 2019 were collected. Also, the UA and spirometry parameters (FEV1, FEV1/FVC) were assessed for patients. All data were analyzed using SPSS version 21 considering a significant level<0.05.

Among 300 patients with asthma, 158 were male, and 142 were female. A significant association was reported between gender, body mass index (BMI), history of smoking, opium consumption, alcohol consumption, number of asthma attacks, family history of asthma, and history of atopy among hospitalized and outpatients (P<0.05). In addition, there was a significant difference between the level of UA in the two groups at the beginning of treatment (P<0.05). Also, a significant difference between the level of UA in hospitalized patients at the beginning and the end of treatment was observed (P<0.05). In addition, a significant difference between the oxygen saturation level among two groups of outpatients and hospitalized patients at the beginning of treatment was seen (P<0.001).

According to our results, the level of UA might be used as a relative predictive factor in the severity of asthma attacks.

 Considering the high prevalence of Coronavirus Disease 2019 (COVID-19) and the medical resource constraints, a better understanding of the characteristics of the disease and identifying the factors indicating the severity of the disease‎ can help decide on the allocation of important and limited resources. The current study aimed to investigate the demographic, clinical, laboratory characteristics, and imaging features of critically-ill patients with COVID-19 who were admitted to the Intensive Care Unit )ICU) of 3 hospitals in Rash City, Iran.

 This retrospective study was performed on 138 patients with COVID-19 who were admitted to the ICU. The study patients’ data, including demographic characteristics, underlying disease, laboratory, imaging findings, and disease outcome were extracted from their records.

 This retrospective study was performed on 138 patients with COVID-19 who were admitted to ICU. Patient data, including demographic characteristics, underlying disease, laboratory and imaging findings, and disease outcomes, were extracted from patient records.

 In this study, the majority of patients were male and in the age range of 55-69 years.  Diabetes mellitus, hypertension, and chronic heart disease were the most common underlying diseases; shortness of breath, fever, and cough were the most common symptoms. Ground glass opacities were the most common sign in lung Computer Tomography (CT) scan and an increase in the level of LDH, ESR, CRP, neutrophil percentage, and lymphopenia were the most common laboratory findings in the study subjects. The mortality rate was equal to 90.58%. 

 This study revealed that most patients with severe manifestations of the disease were older, had a history of underlying disease, symptoms of shortness of breath, cough, and fever, and extensive lung involvement in imaging and changes in laboratory results. Mortality remained high despite medical therapy and mechanical ventilation.

Carbohydrate Antigen 19-9 (CA19-9) is a tumor marker for the prognosis of colorectal and pancreatic cancers. The high level of this tumor marker in gastric cancer indicates the advanced stage and peritoneal metastasis of the tumor. We reported a case of gastric cancer with an extremely high serum level of CA19-9. We also measured the serum levels of carcinoembryonic antigen and Carbohydrate Antigen 125 in the reported case. Such tumor markers manifest the progression and poor prognosis of cancer. Computed tomography data indicated several lytic and sclerotic foci in the inferior thoracic, lumbar vertebrae, and the right iliac wing, along with invasion to lymph nodes and a right adnexal mass in the reported patient. Bone marrow biopsy results revealed that carcinoma cells were predominantly composed of signet ring cell carcinoma. The patient has expired before receiving any interventions for cancer.

Based on the high prevalence of diabetes and depression in Rasht, we conducted a study to evaluate the prevalence of depression in type 2 diabetic patients, and its association with glycemic control, chronic complications, and some clinical and paraclinical parameters in this northern state of Iran.

Beck depression inventory was used for evaluating depression on 90 type 2 diabetics and 90 healthy controls selected. Information on demographic and clinical and paraclinical characteristics was collected by interviews and from medical records.

This cross-sectional study was performed on 90 type 2 diabetic patients (63 female and 27 male with a mean age of 54.17 ± 10.57 years) and 90 healthy matched controls. Overall, depression was significantly more prevalent in case group [37.8% vs. 16%, odds ratio (OR) = 3.29, P = 0.001]. The prevalence of depression in diabetic women was significantly higher than nondiabetic ones (39.7% vs. 15%, P = 0.002). We could not find any significant correlation between depression and positive family history of depression, duration of diabetes, HBA1c level, and body mass index. The prevalence of depression was prominently more in diabetic patients with retinopathy than in those without this complication (55.6% vs. 24%, P = 0.015). Logistic regression analysis indicated that diabetes itself was the only significant determinant of having depression (OR = 3.29, P = 0.005, 95% confidence interval: 0.118-0.667).

There was a prominent prevalence of depression in type 2 diabetics overall. Depression was not correlated with duration of diabetes and glycemic control. There was a significant association between depression and retinopathy in diabetic patients. Diabetes itself was the only significant determinant of having depression after matching with other variables.