فهرست مطالب dariush hooshyar

Patients with respiratory viral infections have altered immune responses, which may predispose them to cardiovascular complications. In the face of the pandemic of a new kind of severe acute respiratory syndrome (SARS), coronavirus disease 2019 (COVID-19), there is a resurgence of interest in the early diagnosis, prevention, and treatment of patients who are at risk. COVID-19 often manifests as viral pneumonia, although extrapulmonary manifestations are also common. Acute cardiac damage associated with elevated high-sensitivity troponin levels crucially contributes to mortality in severe COVID-19. The present review clinically compares cardiovascular complications between COVID-19 and other respiratory infections caused by single-stranded RNA viruses, namely influenza, SARS, and Middle East respiratory syndrome (MERS). Estimating the death rate from RVIs has been a subject of intense research, but the mortality from cardiovascular complications in these infections is less understood and calls for further research.

Brain cancer is recognized as one of the deadliest cancers due to late detection and limitations of therapies. Glioblastoma occurs in different parts of the central nervous system and is the second leading cause of cancer death in people. There are many problems for the treatment of cancer cells. One of the limiting factors is the resistance of cancer cells to chemotherapy drugs. The use of nanoparticles (NPs) is an effective method for overcoming this problem.

Fe3O4 NPs were synthesized, and the size and morphology of NPs were determined by transmission electron microscopy, X-ray photoelectron spectroscopy, and Dynamic Light Scattering. The U87-MG cell line was cultured in Dulbecco’s modified Eagle medium and treated with nano, nano-lomustine, lomustine, and complex with/without magnetic fields. Finally, half maximal inhibitory concentration (IC50), MTT assay, and caspase8 and caspase9 expression were evaluated, and the data were analyzed with SPSS software.

Our results demonstrated that cell apoptosis increased in lomustine and complex groups, especially with the magnetic field (P > 0.05). Based on caspase9 expression analysis, this rate was increased with the magnetic field vs. its absence (P > 0.05).

These findings indicated that a magnetic field, in addition to reducing the effective dose of lomustine, affects apoptosis with a change in the expression of genes involved in this process.

Chronic patients need regular follow-ups. During the COVID-19 pandemic, these regular visits can be affected. The delay of chronic patients and its contributing factors in their periodic visits during the COVID-19 pandemic are examined here. This cross-sectional study was conducted between February and June 2021, in Fars, Iran. Two hundred and eighty-six households with at least one chronic patient were recruited. Then, several trained questioners called the studied households and asked about the studied variables. The dependent variable was the number of delays in regular visits during the COVID-19 pandemic. The results were analyzed through Poisson regression by SPSS Statistics version 22 and GraphPad Prism software version 9. A significance level of 0.05 was considered for this study. Out of 286 households 113 (73.4%) fathers, 138 (70.1%) mothers, and 17 (58.6%) children in the households reported delayed referral. In fathers, referring to the health center was significantly associated with a decrease in the number of delays (P=0.033). The higher age of the householder (P=0.005), the higher number of children (P=0.043), and having a family physician (P=0.007) in the mothers' group, also the number of children in households P=0.001 in the children group were significantly associated with increasing the number of delays. COVID-19 pandemic not only creates direct harmful effects but also adversely affects people in danger of chronic diseases. Delays in follow-ups are taken into account as a major challenge during the COVID-19 pandemic. This issue is not limited to rural or urban residency.

 The COVID-19 pandemic has raised a serious challenge for health care systems, a challenge which requires taking effective and intensive measures to provide patient care. COVID-19 can cause damages to various organs, including heart, through causing various changes in the inflammatory and coagulation systems. Some cases of cardiac injury can display mistakable signs of myocardial infarction (MI). Cardiac injury can mimic acute conditions such as MI.

 In this study, a case of a 33-year-old man with an initial diagnosis of MI by ST-elevation was investigated. He later developed pulmonary thromboembolism (PTE) after being treated with fibrinolytic and anticoagulants; after further investigations, however, he was found not afflicted with primary MI. Our findings may have proven useful in demonstrating the unexpected effects of anticoagulants on COVID-19.

 Miss-diagnosing these cases as well as administrating effective treatment for COVID-19 patients may have posed real risks to the patients and made it difficult to manage them due to the high risk of death and the lack of differential diagnosis of the given patients.

Erythropoietin plays a significant role in the growth of red blood cells, hemoglobin levels, and tissue oxygenation in critically ill patients, as well as anti-inflammatory and neuroprotective effects.

This study aimed to evaluate the effect of recombinant erythropoietin on improving COVID-19 patients.

This study was conducted on 20 COVID-19 participants with hemoglobin of ≥ 9. The inclusion criteria was at least one severe COVID-19 symptom/sign in this interventional study. The primary outcome was a combination of hospital stay length and paraclinical evaluation (LDH and hemoglobin level). The outcomes and side effects were evaluated on day 0 (before the intervention) and five (post-intervention).

The mean hemoglobin level was 10 ± 1.1 gr/dL in the intervention group and 8 ± 0.7 gr/dL in the control group posttreatment, indicating a significant difference between the groups (P = 0.04). The mean hospital stay length (6 ± 2 days) in the intervention group was significantly less than the control group (9 ± 4 days) (P = 0.001). At the end of the treatment, the mean LDH was significantly lower in the intervention group (503 ± 264 µ/L) than in the control group (725 ± 320 µ/L; P = 0.017).

According to the results, this study provides the first solid evidence for the positive effects of recombinant erythropoietin on COVID-19.

COVID-19 is a viral respiratory disease caused by SARS-COV-2, which affects the lower respiratory tract, and causes pneumonia in patients. The disease rapidly spread around the world after the outbreak in late 2019, and became one of the challenges of health care systems. Older adults and patients with underlying diseases such as cardiovascular diseases, hypertension, and diabetes are at a higher risk for COVID-19, and need more care. Due to its prevalence in older adults and normal population, diabetes is important in terms of putting a burden on intensive care systems during the COVID-19 pandemic. Diabetes is also one of the most common comorbidities in patients with COVID-19, which is considered a risk factor for these patients. In addition, the association between diabetes and respiratory distress syndrome is not yet fully understood. Some studies have suggested that diabetes is not associated with respiratory distress syndrome while some others suggest that pulmonary dysfunction follows diabetes. It is also unclear what factors are associated with disease prognosis and mortality in COVID-19 patients with diabetes. In the current study, we aimed to investigate the status of demographic factors, comorbidities, lifestyle and laboratory results in diabetic patients with COVID-19, and compare them with the non-diabetic population and determine the prognostic factors in diabetic patients with COVID-19.

This study is a cross-sectional study performed on 415 patients with COVID-19 in the COVID-19 ward of Shahid Mohammadi Hospital of Hormozgan University of Medical Sciences from February to September 2020. Based on their diabetes, these patients were divided into diabetic and non-diabetic groups. Then, data on demographic factors, smoking, opioids and alcohol consumption, comorbidities (chronic lung disease, asthma, obesity, chronic kidney disease, type 2 diabetes, dementia, malnutrition, chronic neurological disease, rheumatic disease, hypertension, hyperthyroidism, hypothyroidism, favism, hyperlipidemia, and malignant neoplasms), some personal lifestyle features were determined in diabetic patients and compared with non-diabetic populations. Also, the information on biochemical variables, including hemoglobin, white blood cells, lymphocyte, neutrophils, hematocrit, platelets, prothrombin time, alanine aminotransferase, bilirubin, aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, creatinine, blood glucose, sodium, potassium, C reactive protein were measured patients of the two groups. Also, heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, temperature, and oxygen saturation were determined in diabetic and non-diabetic patients.Quantitative variables were described by number (n) and percentage (٪). Qualitative variables were described using mean and standard deviation (SD), median and interquartile range (IQR). The Shapiro-Wilk test was used to assess the normality of quantitative variables. Independent t-test or Man-Whitney U test, and Chi-square or Fisher's exact tests were used to compare variables. In all statistical analyses, a p-value less than 0.05 was considered statistically significant. Statistical analysis was performed by IBM SPSS version 22 (IBM Corporation, Armonk, NY, USA).

The findings of our study showed that in the diabetic patients’ group 82 patients (41.2%) and in the non-diabetic population 135 patients (55.32 %) were men. In the diabetic group, the mean age of recovered patients was 58.52 years and the mean age of those in the deceased was 57.73 years, which was not statistically significant. In the non-diabetic group, the mean age of patients recovered was 47.98 years and the mean age of those in the deceased was 62.58 years, which was statistically significant (p <0.001). In the diabetic population, 773 patients (42.69 %) and in the non-diabetic population, 132 patients (54.09 %) had positive PCR. In the diabetic population, 18 patients (10.59 %) and in the non-diabetic population, 10 patients (4.09 %) had chronic kidney disease. In the diabetic population, 11 patients (6.43 %) and in the non-diabetic population, 13 patients (5.32 %) smoked. In the population of diabetic patients, the mean level of hemoglobin (P = 0.002) and lymphocyte count (P = 0.043) in the living cases were significantly lower than those in the deceased. The mean levels of neutrophils (P = 0.012), aspartate transaminase (P = 0.020), lactate dehydrogenase (P = 0.041), blood urea nitrogen (P = 0.003), and creatinine (P = 0.011) in the diabetic population were significantly higher in the living cases than those in the deceased, but the comparison of these cases in the non-diabetic population did not show a significant difference.In diabetic patients, there was a significant difference between the number of survival and death in each group of positive and negative PCR (P = 0.011); While the difference in mortality and survival between PCR positive and negative groups in non-diabetic subjects was not significant. In diabetic patients, a significant difference was also reported between the number of survival and death in groups with CKD and without CKD; while in non-diabetic participants there was no significant difference between CKD and non-CKD groups in terms of survival and death. Corticosteroid treatment also significantly led to a difference in the number of survival and death cases among the diabetic population, but a comparison of these cases in the non-diabetic population did not show a significant difference.In the group of diabetic patients, respiration rate (number of breaths per minute) was significantly lower among the living cases compared to those in the deceased (P < 0.05), while our findings in this regard did not show a significant difference in non-diabetic individuals. Also, in diabetic patients, the amount of oxygen saturation was significantly higher among the living cases than those in the deceased (P < 0.05), in which case the same results were observed in non-diabetic patients (P < 0.05).

In this study, the mortality rate in diabetic patients was significantly associated with lymphopenia, elevated aspartate transaminase, lactate dehydrogenase, blood urea nitrogen, and creatinine compared to non-diabetic patients.  Our findings suggest that individuals with type 2 diabetes are more prone to complications of COVID-19 and its related mortality; therefore these patients need more medical attention in the COVID-19 pandemic. Also, considering that so far limited studies have focused on the possible differences in the complications of Covid-19 disease and its mortality in diabetic individuals compared to non-diabetic individuals, it is recommended that more studies with higher sample sizes in other populations be performed to confirm the results of the present study.

 As the first randomized clinical trial, this study evaluated the effect of Famotidine on the improvement of outcomes of hospitalized patients with COVID-19.

This phase III randomized clinical trial which was designed with two parallel arms, is a placebo-controlled, single-blind, and concealed allocation study, and recruited 20 patients (10 of them received Famotidine as treatment group and 10 received Placebo as control group). Oral Famotidine 160 mg four times a day was given to the COVID-19 patients until the discharge day or for a maximum of 14 days. Patients’ temperature, respiration rate, oxygen saturation, lung infiltration, lactate dehydrogenase (LDH) level, and complete blood count (CBC) were measured at the baseline (before the intervention) and on day 14 after the intervention or on discharge day. Length of stay in the hospital and length of stay in the ICU were also measured as secondary outcomes of the study.

The results showed a significant decrease in LDH (P=0.01), mean WBC (P=0.04) and length of stay (P=0.04) of patients with COVID-19 in the group treated with Famotidine compared to the control group. There was also a significant increase in oxygen saturation (P=0.01) in the group treated with Famotidine compared to the control group. Cough improvement was also higher in the oral Famotidine group compared to the control group (P=0.02).

This was the first clinical trial on the effect of Famotidine on the improvement of hospitalized COVID-19 patients, which indicated that high-dose Famotidine improves patients’ clinical signs and reduces the severity of the disease and duration of hospitalization.

Coronavirus disease 19 (COVID-19) can cause many radiological manifestations on chest computed tomography (CT) scans. However, the occurrence of pneumomediastinum is rare in these patients. Accordingly, this study represents the rare cases encountered during the COVID-19 epidemic.

This study focuses on describing three patients who attended our medical center during the COVID-19 epidemic showing pneumomediastinum on chest CT scans. Patients’ COVID-19 was confirmed after positive polymerase chain reaction tests. Finally, two of them were expired despite the efforts of the medical team.

Overall, the results of this study suggest the occurrence of pneumomediastinum on the CT scans of patients as a possible finding of COVID-1

Long-term use of central venous catheters is common in cancer patients for chemotherapy. The remaining of these catheters after the end of the treatment period can be associated with complications such as thrombosis and catheter fragmentation.

This report presents a 42-year-old woman with a history of colon cancer whose inner part of the vascular access was detached from the outer part after removing the central venous catheter, and the catheter remained inside the internal jugular vein. After preparing the patient’s chest X-ray, the catheter was removed from the femoral vein by percutaneous retrieval and successfully taken out using the snaring technique.

Overall, percutaneous retrieval is a safe way to remove intravascular foreign bodies that can prevent major surgical complications.

This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity.

This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity.

Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively).

There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.

There are few studies showing the association between vitamin D deficiency and COVID-19 severity and mortality. This study designed to investigate the relationship between vitamin D deficiency and the severity and mortality of COVID-19.

The present cross-sectional study was conducted on 48 COVID-19 patients with positive PCR test results. Patients were divided into three groups according to their serum 25-OH vitamin D3 levels: group 1 <20 ng/mL, group 2. 20-50 ng/mL, and group 3, ≥50 ng/ml. The relationship of the levels of vitamin D3, as well as the history of diabetes, hypertension, Ischemic Heart Disease (IHD), Glomerular Filtration Rate (GFR) ≤60 mL/min, LDH ≥500 U/L, and Lymphocyte count ≤1500 with the severity of the disease and its mortality were investigated.

A significant relationship was observed between vitamin D ≤20 ng/mL and the severity (P<0.001) and mortality (P=0.001, adjusted OR=2.4) of the disease in COVID-19 patients. It was also shown that GFR ≤60 mL/min (P=0.02, adjusted OR=3.6), IHD (P=0.04, adjusted OR=2.8), LDH ≥500 U/L (P=0.027, adjusted OR=1.8), and lymphocyte count ≤1500 (P=0.002, adjusted OR=2.2) significantly affected the mortality.

The present study showed a significant relationship between vitamin D deficiency and the severity of the disease and mortality in COVID-19 patients. These results suggest the need for appropriate health policies during the COVID-19 pandemic.

Autophagy is a way to create new cellular structures, clear cells invaded by microbes, and block accumulating proteins that can cause disease. Moreover, it can destroy all cellular organs and pathogens, including fungi, parasites, bacteria, and viruses, either randomly or selectively. Many research groups are examining a strategy to combat COVID-19. In particular, research is underway to identify drugs that can target autophagy in COVID-19 virus infection. Several known drugs are currently under clinical evaluation for the autophagy process, given that regulating autophagy is a way to combat COVID-19. This study introduces drugs that target the autophagy pathway.

 Aleebrahim-Dehkordi E, Saberianpour S, Soleiman-Dehkordi E, Hooshyar D, Mojtahedi Z, Kianpour N, Hasanpour-Dehkordi A, Saberian L, Akhavan Sepahi M. Autophagy and treatment of patients with COVID-19; which drugs target the autophagy pathway? J Nephropathol. 2022;11(1):e01. DOI: 10.34172/jnp.2022.01.

The severe acute respiratory syndrome coronavirus 2 virus and its associated disease, called coronavirus disease 2019 (COVID-19), first appeared in Wuhan, China in December 2019 and quickly spread around the world. Coronavirus was officially named COVID-19 by the World Health Organization and was recognized as a pandemic due to its rapid spread worldwide. Based on the published data, it is hoped to provide a source for later studies and to help prevent and control the contagious COVID-19 and its characteristics, and considerations that surgeons and medical staff must observe during the epidemic

No specific study has investigated the effect of non-steroidal anti inflammatory drugs (NSAIDs) and especially the effects of Ibuprofen on COVID-19, so far.

The purpose of this study was to investigate the effect of Ibuprofen on the severity of COVID-19 and mortality caused by the disease.

This study was conducted on 158 patients with COVID-19 who had consumed Ibuprofen, Gelofen, and Novafen for at least one week in the last three months. Patients were divided into three groups (mild, moderate and sever). The relationship among the severity of the disease and the history of ibuprofen consumption, diabetes, history of cardiovascular problems, hypertension, and GFR was investigated. Also, the association between the history of ibuprofen consumption, GFR ≤ 60 mL/min, hypertension, LDH ≥ 500 U/L, lymphocyte count ≤ 1500, and mortality was examined.

Our findings showed a significant relationship between the history of Ibuprofen before COVID-19 and the severity of COVID19, as well as the mortality rate (P value < 0.001, adjusted odd ratio: 2, respectively). This study also showed a significant relationship among the severity of the disease and the history of smoking, diabetes, hypertension, history of cardiovascular diseases, and GFR. In addition, a significant relationship was found among GFR ≤ 60 mL/min mortality, diabetes, LDH ≥ 500 U/L, and lymphocyte count ≤ 1500.

Our study showed a significant relationship between the history of the consumption of ibuprofen and its compounds before COVID-19 and the severity of COVID-19, as well as themortality rate of the patients with this disease, and accordingly, this result can suggest health policies during the epidemic of COVID-19.