فهرست مطالب mahin ghorban sabbagh

Hospital readmission after kidney transplantation is a real challenge for both patients and healthcare systems. Assessment of the risk factors of readmission after kidney transplantation is vital and can reduce morbidity and cost in transplant recipients and donors. The aim of the current study was to determine the risk factors of hospital readmission in patients undergoing kidney transplantation in Montaserieh Hospital of Mashhad, northeast of Iran.

This retrospective study included 523 first kidney transplant patients between January 2013 and March 2019 from the Montaserieh Hospital Information System (HIS) of Mashhad, Iran. Every-time readmission was the study primary outcome. Donors and recipientchr('39')s demographic data, recipientchr('39')s comorbidities, reasons for end-stage renal disease (ESRD), panel reactive antibody (PRA) status, dialysis parameters, cold ischemic time, and delayed graft function (DGF) were the potential risk factors. Statistical analysis was done using chi-square and Studentchr('39')s t-test.

Data from 523 patients were assessed for potential eligibility. Based on the exclusion criteria, data from 479 patients were included in the final analysis. 174 (36.3%) patients were never readmitted, and 305 (63.7%) were readmitted at least once post-discharge. 39 (12.8%) were readmitted within the first month post-discharge. Older age, sex, higher prevalence of comorbidities, diabetes and hypertension, duration of primary disease before transplantation, hemodialysis and duration of pre-transplant dialysis, mean pre-transplant platelet count, intraoperative complications, increased cold ischemic time, and delayed graft function was associated with a higher prevalence of readmission (p < 0.05).

Our results showed that different independent variables and patientschr('39') comorbidities were important risk factors for readmission after kidney transplantation. Early prediction of these risk factors could result in the prevention of readmission in patients undergoing kidney transplantation.

Pre-transplant serum phosphorus level is shown to be associated with some transplant outcomes in patients with chronic kidney disease. However, its association with Delayed graft function (DGF) has an aura of ambiguity. DGF means either the patient needs dialysis during the first week after transplantation or the creatinine level is ≥ 3. This study was aimed to assess the relationship between pre-transplant serum phosphorus levels with DGF.

A total of 306 patients, who had undergone kidney transplantation in the Montaserieh organ transplantation hospital in Mashhad, Iran, during 2016 to 2019; were enrolled in this study. Demographic data and clinical characteristics of patients including dialysis type and duration, donor type, medications, pre-transplant serum levels of calcium, phosphorus and DGF development were measured. Then, all patients were divided into five groups according to their serum phosphorus: P < 3.5, 3.5 ≤ P < 5.5, 5.5 ≤ P < 7.5, 7.5 ≤ P < 9.5, and P ≥ 9.5 mg/dL. The association with DGF was evaluated by statistical analysis.

Patients age ranged from 18.00 to 64.00 years old, with an average of 37.08 ± 10.9. About 55.6% of them were men, and 26.1% came up with DGF. Among patients with DGF, 36.25% were recipients with pre-transplant phosphorus level of 3.5 ≤ P < 5.5 and 50% of 5.5 ≤ P < 7.5.

Our study suggested that pre-transplant serum phosphorus might be associated with an increased risk of delayed graft function. Further studies are needed to assess, whether adjusting serum phosphorus level before kidney transplantation could reduce delayed graft function or not.

 Knowing the national statistics of glomerular diseases will help in the management and minimizing their burden in the community. The aim of this study was to assess the overall distribution of subtypes of glomerulonephritis (GN) and the prevalence of renal diseases in a subgroup of diabetic and hypertensive patients.

This cross-sectional study was conducted on 860 patients with different subtypes of GN diagnosed by percutaneous renal biopsy and histological examination.

The most common subtype of GN was membranous GN (30.1%) followed by minimal change disease (20.1%), IgA nephropathy (9.5%) and Lupus nephritis (8.8%), as well as membranoproliferative GN (6.4%), focal segmental GN (5.6%), crescent GN (43, 5%), and DM nephropathy (36, 4.2%). IgA nephropathy and focal segmental GN were mostly common among maleswhile the most female dominant GN was Lupus nephritis. Lupus nephritis was the most common GN diagnosis among subjects who were younger than 29 years old (50%), while the diabetic nephropathy was the most common GN diagnosis among subjects who were older than 53 years old (44.4%). The most common GN among hypertensive subgroups was focal segmental GN (41.7%) followed by diabetic nephropathy (33.3%) whereas the most common subtypes of GN among diabetics was diabetic nephropathy.

The most common type of GN among Iranian population in Mashhadwas membranous GN and minimal change disease. The distribution of each subtype of glomerular disease depend on the baseline determinants including age, gender and hypertensive state.

An important stage in medical training is pathophysiology level. There is a question among medical teachers that conventional method of teaching is sufficient for learning. There is purpose among teachers to find a way to improve the quality of medical teaching. The aim of this study was to compare lecture and blended methods to each other.
121 medical students of Mashhad University of medical science in this quasi-experimental study were enrolled. These students had selected kidney pathophysiology course in the academic year 2016. The teachers randomly divided into two groups as lecture group and blended group. Finally, the student’s satisfaction was assessed with a in the two groups were evaluated. The questionnaire assessed by likert scale. The data were analyzed through INSTAT software using t-test.
According to questionnaire results students believed that the blended method leads to: more interest to class (62%), better knowledge per durability (72.8%) , better relationship between teachers and students (58.7%), better explanation (68.6%), and more friendly atmosphere of class (47.1%).
According to the results of this study blended teaching method increased students'' satisfaction. This method can be used in teaching kidney physiopathology