Baqiyatallah Hospital Research Articles

Surveying haemoperfusion impact on COVID-19 from machine learning using Shapley values.

Haemoperfusion (HP) is an innovative extracorporeal therapy that utilizes special cartridges to filter the blood, effectively removing pro-inflammatory cytokines, toxins, and pathogens in COVID-19 patients. This retrospective cohort study aimed to assess the clinical benefits of HP for severe COVID-19 cases using Shapley values for machine learning models. The research involved 578 inpatients (≥ 20years old) admitted to Baqiyatallah hospital (Tehran, Iran). The control group (359 patients) received standard treatment, including high doses of corticosteroids (a single 500mg methylprednisolone pulse, followed by 250mg for 2days), categorized as regimen (I). On the other hand, the HP group (219 patients) received regimen II, consisting of the same corticosteroid treatment (regimen I) along with haemoperfusion using Cytosorb H300. The frequency of haemoperfusion sessions varied based on the type of lung involvement determined by chest CT scans. In addition, the value function defines the Shapley value of the th feature for the query point , where the input matrix features represent individual characteristics, drugs, and history and clinical conditions of the patient. Our data showed a favorable clinical response in the HP group compared to the control group. Notably, one-to-three sessions of HP using the CytoSorb® 300 cartridge led to reduced ventilation requirements and mortality rates in severe COVID-19 patients. Shapley values were calculated to evaluate the contribution of haemoperfusion among other factors, such as side effects, medications, and individual characteristics, to COVID-19 patient outcomes. In addition, there is a significant difference between the two groups among the treatments and medications used remdesivir, adalimumab, tocilizumab, favipiravir, Interferon beta-1a, enoxaparin prophylaxis, enoxaparin full dose, heparin prophylaxis, and heparin full dose (P < 0.05). It seems that haemoperfusion has a positive impact on the reduction of inflammation markers and renal functional such as ferritin and creatinine, respectively, as well as D-dimer and WBC levels in the HP group were significantly lower than the control group. The findings indicated that haemoperfusion played a crucial role in predicting patient survival, making it a significant feature in classifying patients' prognoses.

Human Papillomavirus Genotype Distribution in a Hospital-based Single-Center Study

Background: Cervical cancer is reported as one of the most prevalent malignancies worldwide in women. There is a substantial connection between cervical diseases and infection with Human Papillomavirus (HPV), especially Types 16 and 18 of HPV. Objective: This study aimed to assess the HPV genotype distribution to determine its most common type at a referral hospital in Iran. Methods: This cross-sectional study was conducted on 400 women with positive HPV result tests who visited the gynecologic oncology clinic of Baqiyatallah Hospital from 2017-2021. Results: The average age of subjects was 37.46±9.75 years (range=19-74). About 167 (41.8%) of the patients were between 25 to 35 years. The analysis showed that 137 (34.2%) patients had only low-risk (LR) typing, 129 (32.2%) patients had only high-risk (HR) typing, and 134 (33.5%) patients had both HR and LR typing. The most frequent LR HPV types were HPV 6 (18.5%) and 11 (17%), and the most frequent HR HPV types were HPV-16 (14.7%), 52 (8.2%), 18, and 31 (6.5%). Conclusion: This study showed that the most frequent age category in both low- and HR HPVpositive women is the age 25 to 35 years. The second most common HR-HPV subtypes included HPV-52, not HPV-18, which indicates variations in HR-HPV subtypes in different populations and races and warrants further research.

Estimating the Costs of End-of-Life Care in Patients With Advanced Cancer From the Perspective of an Insurance Organization: A Cross-Sectional Study in Iran

ObjectivesCancers are significant medical conditions that contribute to the rising costs of healthcare systems and chronic diseases. This study aimed to estimate the average costs of medical services provided to patients with advanced cancers at the end of life (EOL). MethodsWe analyzed data from the Sata insurance claim database and the Health Information System of Baqiyatallah hospital in Iran. The study included all adult decedents who had advanced cancer without comorbidities, died between March 2020 and September 2020, and had a history of hospitalization in the hospital. We calculated the average total cost of healthcare services per patient during the EOL period, including both cancer-related and noncancer-related costs. ResultsA total of 220 patients met the inclusion criteria. The average duration of the EOL period for these patients was 178 days, with an average total cost of $8278 (SD $5698) for men and $9396 (SD $6593) for women. Cancer-related costs accounted for 64.42% of the total costs, including inpatient and outpatient services. Among these costs, hospitalization was the primary cost driver and had the greatest impact on EOL costs. This observation was supported by the multiple linear regression model, which suggested that hospitalization in the final days of life could potentially drive costs in these patients. Notably, no specialized palliative care was provided to the patients included in this study. ConclusionsThe results demonstrate that there is a significant rise in costs of care in patients receiving routine cancer care rather than optimized EOL care.

Correlation of the COVID-19 Infection and Outcomes with Workload among Emergency Healthcare Workers in an Iranian Referral Hospital.

The immediate spread of COVID-19 posed a great deal of strain on healthcare personnel, particularly emergency personnel. Considering the critical role of frontline health care personnel (HCPs) during the pandemic and the life-threatening effects of COVID-19 on them, the present study aimed to evaluate the hospital database among frontline emergency personnel, and to assess the factors affecting the health status of the emergency HCPs. In the current study, we collected data on coronavirus clinical features from 58 HCPs with confirmed COVID-19 who worked in the emergency ward of Baqiyatallah Hospital, Tehran, one of the most referral hospitals in Iran. We also assessed the factors affecting the health status of the emergency HCPs from February 2020 to November 2020. All of the 58 HCPs infected with COVID-19 were the personnel of the emergency ward with an age range of 20-59 years old. The median (interquartile range) of hospital length of stay (LOS) among all patients was 8 days. Length of stay is a critical factor in predicting hospital resource needs. Twelve (21.8%) patients had ground-glass opacity (GGO) alone, and 20 (35.7%) patients had patchy GGO. In our multivariable analysis, high levels of patient liver enzymes (P=0.04) and lymphopenia (P=0.01) were significantly associated with the LOS. In our study, there was an association between high levels of patient's ESR and CRP and longer LOS. We also found that age and gender had no effect on LOS. Nurses contributed to the highest number of COVID-19 infection. It was also found that HCPs who had more working shifts were more infected, and the intensive care unit of the emergency ward was the most infected area of the Emergency Room.

Effects of a Computer-Based Intervention on Sustained Attention, Divided Attention, and Impulsivity in Children with Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder (ADHD) is a condition that causes poor academic performance. If left untreated, it can lead to different comorbidities such as depression, anxiety, and substance abuse. Objectives: This study compared the effects of a computer-based intervention (Captain's Log MindPower Builder) combined with Ritalin to those of Ritalin alone on sustained attention, divided attention, and impulsivity in children with ADHD. Methods: The statistical population included all boys and girls with ADHD aged 7 - 12 years who visited Baqiyatallah Hospital of Tehran in 2021 (N = 103). Purposive sampling was employed to select 30 eligible children as the research sample. They were then randomly assigned to an intervention group (Captain's Log MindPower Builder + Ritalin) and a waitlist control group (Ritalin alone). The computer-based intervention was performed in twelve 60-minute sessions. The data were collected by conducting the Integrated Visual and Auditory Continuous Performance Test. The analysis of covariance (ANCOVA) was then utilized to analyze the research data. SPSS software v26 was used for data analysis. Results: The mean ± SD of sustained attention, divided attention and impulsivity were 78.26 ± 6.90, 80.20 ± 6.01, and 73.70 ± 8.91on the pretest in the intervention group; moreover, it was 88.87 ± 7.19, 90.94 ± 5.45, and 82.41 ± 8.46 on the pretest in the control group. According to the results, the computer-based intervention had significant effects on both sustained attention and divided attention; however, it failed to significantly improve impulsivity (P &lt; 0.001). Additionally, the intervention effects during the 45-day follow-up period only showed stability for sustained attention (P &lt; 0.001). In fact, its effects on divided attention and impulsivity control were not significant. Conclusions: The computer-based intervention enhanced Ritalin's effects in some ways and improved sustained attention. Therefore, education centers for children with ADHD are recommended to adopt this method in order to improve attention in such children. Nevertheless, further studies are needed in this field to gain a better insight into the effectiveness of Captain's Log MindPower Builder.

Investigating the Efficacy of an Herbal Medicine Package (Anti-Flu Pulmo-Health) Along with Common Medications in Alleviating COVID-19 Symptoms in Outpatients: A Double-Blinded Randomized Controlled Trial

Background: To date, no specific medication has been shown to be effective in treating COVID-19. Objectives: Due to the role of medicinal plants in reducing the symptoms of viral diseases, the present study aimed to assess the efficacy of an herbal medicine package (anti-flu Pulmo-Health), prepared based on Persian traditional medicine instructions and bioinformatics studies, in reducing the symptoms of COVID-19 in outpatients. Methods: This double-blinded randomized controlled trial was conducted on 60 COVID-19 outpatients referred to the Emergency Department of Baqiyatallah Hospital in Tehran (Iran) in July-Sep. 2020. The patients were randomly assigned into two groups, the control group (receiving routine treatment and a placebo) and the intervention group (receiving routine treatment plus anti-flu Pulmo-Health syrup and supplementary drops). The intervention continued for 10 days. The primary outcomes were oxygen saturation level, respiratory rate, heart rate, frequency of coughs during day and night times, shortness of breath score (based on the SOBDA questionnaire), expectoration, as well as the frequency of dry and productive coughs. Secondary outcomes were systolic and diastolic blood pressure, body temperature, headache, nausea, and chills. Results: In this study, 55 COVID-19 patients (27 cases in the control group and 28 subjects in the intervention group) were analyzed. The mean age of the patients was 46.25 ± 12.84 years, and 65% of them were female. The two groups of patients were homogenous in terms of demographic characteristics. The results showed that COVID-19 patients who received routine treatment plus the herbal syrup and supplementary drops revealed significantly better therapeutic responses in terms of respiratory rate, oxygen saturation, expectoration (P &lt; 0.001), frequency of dry and productive coughs (P &lt; 0.001), frequency of coughs, and shortness of breath (P &lt; 0.001). Conclusions: As evidenced by the results of this study, the higher therapeutic response of COVID-19 outpatients to the anti-flu herbal syrup, this medicine is recommended as a supplement to improve respiratory symptoms in COVID-19 patients.

Assessment and Reduction of Human Error using SHERPA Technique in Chemotherapy Department of a Large Military Hospital.

Medical errors are numerous in medical activities. Considering the sensitivity and importance of the medical group's professions, the emergence of an apparently simple error can cause the death of an individual or even a group of individuals. The present study aims the evaluation and reduction of human error using a system human error reduction and prediction approach System Human Error Reduction and Prediction Approach (SHERPA) in the nurses of Baqiyatallah hospital's chemotherapy ward in 2019. A cross-sectional study was conducted in the chemotherapy ward using the SHERPA technique. Then, the duties were determined in detail using Hierarchical Task Analysis (HTA). The errors were identified using the SHERPA checklist, and the risk outcomes and intensities were finally evaluated. Based on the study findings, there are 109 possible errors for 48 sub-duties. The most frequent errors fall in the functional area (54%) and the least frequent errors pertain to the area of selection (3%). In order to reduce the errors and increase the quality of the services and safety of the patients, errors can be identified by using the SHERPA technique; after identifying these errors, using this technique, it is possible to prevent the recurrence of the identified errors by careful planning. Considering the fact that the most frequent error was found in the functional domain, modern protocols can be codified in this area, and standards can be observed for putting the problems of this section atop of the priority list and reducing the errors and increasing safety of the patients.

A Comparative Study of Patients’ Trust in Physicians and Nurses in COVID-19 and Non-COVID 19 Wards in a Reference Hospital in Tehran, Ira

"Trust in health care professionals is considered as a basis for patients’ care. This study aimed to compare the level of patients' trust in physicians and nurses in both general and COVID-19 wards in a reference hospital in Tehran during the pandemic. This was a cross-sectional descriptive study. The study population comprised patients from Baqiyatallah Hospital in 2022. The data collection tool was the scale of patients’ trust in nurses and the Wake-Forest physician trust scale. Data analysis was performed using SPSS-26 software. The level of patients’ trust in physicians in COVID-19 wards was significantly lower than in Non-COVID-19 wards (P&lt;0.001), but there was no difference between the two groups in the trust of nurses. The lowest level of trust was in the receiving of required information from nurses, which had a lower score compared to other questions in the questionnaire, and the average amount of receiving required information for patients in general wards was significantly lower than that of patients in COVID-19 (P=0.006). Trust in nurses and physicians in both COVID-19 and general wards was optimum. During the COVID-19 pandemic, the medical staff worked tirelessly and despite the difficulties and complications of the pandemic, patients have high trust in physicians and nurses. "

Covid-19 Risk Perception in a Sample of Iranian Population

"How people behave in an emergency depends on many social, cultural, and contextual factors. This study aimed to determine the COVID-19 risk perception in Iranian people. This study was descriptive. The study population was the assistant of patients who had come to Baqiyatallah Hospital in 2021. The number of participants was 500. The study tool was the COVID-19 risk assessment questionnaire. Data were analyzed using SPSS-22 software. The mean risk perception score was 2.78(±0.6) on a 7-point scale. The lowest and highest mean of the predictors of risk perception in COVID-19 was trust in government and personal efficacy, respectively. There was a significant difference between men and women in the mean of collective efficacy (P= 0.032). Social knowledge (p=0.007), trust in science (p=0.001), and trust in medical professionals (p=0.050) in positive direct experience people were significantly more than in people with negative direct experience of COVID-19. The most important predictors of risk perception in the COVID-19 epidemic were gender, education, social knowledge, and trust in science (P&lt;0.05). People's perception of the risk of COVID-19 depends on several various factors, the most important factors were gender, level of education, social knowledge, and people's trust in science. "

Comparison of Knee Proprioception between Athletes with Anterior Cruciate Ligament Injury and Healthy Athletes

Introduction: In addition to the instability of the knee joint, injury to the anterior cruciate ligament (ACL) leads to a functional deficit in the form of diminished proprioception of the knee joint. The purpose of this study was to compare knee proprioception in athletes with an ACL injury and healthy athletes.&#x0D; Materials and Methods: The participants in this cross-sectional study were 26 athletes with an ACL injury and 24 healthy athletes who were selected from the orthopedic clinic at Baqiyatallah Hospital in 2019, Tehran City, Iran. Cooper or non-Cooper subjects with ACL injury were identified via the knee injury and osteoarthritis outcome score (KOOS). The knee proprioception of all participants was recorded using a system consisting of digital photography, non-reflective markers, and Digimizer software.&#x0D; Results: The results showed that there was no significant difference between groups in the absolute error of knee joint reconstruction at both 45° and 90° angles.&#x0D; Conclusion: The data of the study showed that in comparison with healthy athletes, the knee joint proprioception of athletes with an ACL injury is not different and has the same function.

Antimicrobial Resistance Profile of Extended-spectrum Beta-lactamase Genes in Escherichia coli Isolates Using Multiplex PCR Technique

Background: Broad-spectrum antibiotic resistance genes are one of the most common developing resistance genes worldwide. Accordingly, it is of paramount importance to study the extended-spectrum beta-lactamase genes to report them to physicians to select the most appropriate treatment. Objectives: This study aimed to detect three genes of ESBL such as TEM, AmpC, and KPC simultaneously. Methods: Primers were designed for ESBL genes such as TEM, AmpC, and KPC with Genscript software. In this study, control-positive genes were used for the PCR set-up. Fifty isolates of Escherichia coli isolated in the Baqiyatallah Hospital were confirmed and checked by Multiplex PCR. Results: This study revealed that TEM, AmpC, and KPC primers could detect positive control genes. The sensitivity and specificity of the multiplex PCR technique for these genes were 0.001 ng and 100%, respectively. Conclusions: This study revealed that a Multiplex PCR with a sensitivity of 0.001 ng and 100% specificity can detect ESBL genes precisely. Accordingly, the rapid and precise detection of the antibiotic resistance genes and the recommendation of an appropriate treatment pattern can decrease the distribution of antibiotic resistance occurrence and economic cost.

Evaluation of Frequency and Type of Severe Anemia in Patients Referred to the Baqiyatallah Hospital in Tehran in Six Months; A Descriptive Cross-Sectional Study

Purpose: To investigate the frequency and types of severe unknown anemia in patients referred to the Baqiyatallah Hospital (Tehran) for six months.&#x0D; Methods: In this descriptive cross-sectional study, the patients with severe unknown anemia referred to the Baqiyatallah Hospital (Tehran, Iran) were selected over six months. Following consideration of inclusion and exclusion criteria, 230 patients with severe anemia (hemoglobin (Hb) &gt; 8gr/dl) were included. Complete medical history was obtained from the patients and additional biochemical blood analyses were applied to determine the frequency and type of anemia. SPSS (v.19) software was used to analyze the findings and the significance level was defined as a p-value &lt;0.05.&#x0D; Results: In chronic disease anemia (47.5%), gastrointestinal bleeding-associated anemia (29%), bleeding malignancies anemia (21.5%), and aplastic anemia (2%). There were significant differences (p&lt;0.05) in the frequency of different types of normocytic anemia. The highest frequency was detected in folate deficiency anemia (46%), hypothyroidism anemia (34%), and B12 deficiency anemia (20%), respectively. The hemolytic anemia represented a significant difference (p&lt;0.05) in comparison with sickle cell anemia (95%). Also, sickle cell anemia showed a significant difference (p&lt;0.05) between thalacemia-associated anemia (95%) and malignancy-related anemia (95%)&#x0D; Conclusion: Respectively, the highest frequency of anemia in patients was found in chronic diseases and gastrointestinal bleeding. It is suggested that more attention should be paid to the type of anemia of patients referred to the urgency of hospitals.

Prevalence and Associated Risk Factors of Intestinal Parasitic Infections among Patients Visiting a Referral Hospital in Tehran Province, Iran.

Intestinal parasitic infections (IPIs) are still considered a public health problem of mankind, particularly in immunocompromised patients. We aimed to determine the prevalence of IPIs with an emphasis on immunocompromised patients in a referral hospital in Tehran Province, Iran. In this cross-sectional study, 442 fecal specimens were collected randomly from patients, referred to Baqiyatallah Hospital in Tehran Province, Iran from May to September 2020. The collected specimens were examined using wet-mount, trichrome and modified Ziehl-Neelsen staining, formalin-ether concentration, and agar plate culture. The prevalence of IPIs was found 17.0% (95% CI: 13.6-20.8%). The prevalence of protozoan parasites (16.3%; 95% CI: 13.0-20.1%) was significantly higher than helminthic parasites (0.7%; 95% CI: 0.1-2.0%). Blastocystis spp., Giardia lamblia, and Entamoeba coli were the most common intestinal protozoan with a prevalence of 12.2%, 1.6%, and 1.4%, respectively. E. histolytica/E. dispar/E. moshkovskii, Iodamoeba bütschlii, Cryptosporidium spp., Chilomastix mesnili as protozoan species and Hymenolepis nana, Dicrocoelium dendriticum, and Ascaris lumbricoides as helminthic species were the other detected parasites. Multiple logistic regression revealed a significant association of IPIs infections with stool consistency and the status of immune system. The prevalence of IPIs among the patients who are immunocompromised was significantly higher than immunocompetent patients (P< 0.05). Periodic stool examinations for screening of IPIs should be included as a part of routine medical check-up in these patients.

Psychometric Properties of the "Quality of Life in Life-Threatening Illness-Family Carer Version" (QOLLTI-F) in Persian-Speaking Carers of COVID-19 Patients.

BackgroundMeasuring family caregivers’ quality of life plays a significant role in improving the quality, efficiency, development, and provision of efficient services for patients with COVID-19. As a result, evaluating the quality of life requires the use of valid and reliable measures that are culturally appropriate. This study was conducted to determine the psychometric properties of the Persian version of the Quality of Life in Life-Threatening Illness–Family Carer Version (QOLLTI – F) in patients with COVID-19.MethodsThis methodological study was carried out in 2021 at Baqiyatallah Hospital in Tehran. After gaining approval from the tool creator, the translation was carried out utilizing the forward-backward approach. Cognitive interviews with 10 family caregivers of COVID-19 patients were used to demonstrate face validity. Moreover, construct validity was identified by performing exploratory factor analysis (EFA) (n = 251), confirmatory factor analysis (CFA) (n = 200), and convergent validation using Zarit Burden Interview (ZBI) questionnaire. For scale reliability, internal consistency and stability were performed using Cronbach’s Alpha Coefficient and test-retest, respectively.Results451 family caregivers of patients with COVID-19 were enrolled in this study. Three factors with a cumulative variance of 51.85% were extracted during EFA: (1) Caregiver’s physical-emotional status, (2) Satisfaction with the situation, and (3) Caregiver’s concerns. CFA showed that the model enjoyed a moderate to a good fit of information (RMSEA: 0.087; NFI: 0.98; CFI: 0.91; IFI: 0.91; GFI 0.89; standardized RMR: 0.070). A significant correlation was found between the Persian version of the ZBI and participants’ total scores of QOLLTI – F v3 (r = –0.196, P = 0.000). Cronbach’s Alpha Coefficient = 0.719 and ICC stability reliability = 0.71 of the questionnaire were confirmed.ConclusionThe Persian version of the QOLLTI – F v3 is a valid and reliable scale that can measure family caregivers’ quality of life during a Life-Threatening illness in patients with COVID-19. This instrument may be utilized in clinical trials and research to enhance the quality of life for family carers in Iranian society.

CT angiographic study of hepatic arteries variants in Iranian subjects

This retrospective study aimed to assess the anatomical variations of hepatic arteries (HAs) in Iranian subjects referred to the Baqiyatallah Hospital (Tehran, Iran) as a reference medical center. The presence of anatomical variations such as hepatic arteries (HA) is approved among different societies. Classification of common patterns and probable variants of HA seems necessary in preoperative precautions of hepatosurgeries. Multidetector computed tomography angiography scans were prepared from the patients referred to the Baqiyatallah Hospital from January 2019 to January 2020. Inclusion and exclusion criteria were assessed, and all patterns of hepatic arterial supply were evaluated in 240 cases based on Michels’ classification of HA. Following the assessment of 240 patients, HA variants with aberrant origin (types of II-VIII) were detected in 55 cases (22.92%). Besides, no patients were reported as types of XI and X variants (n=0). Also, no relationship was found between the HA and gender. Detection of common patterns along with abnormal variations of HA variants is necessary for hepatosurgical procedures. We found that 22.92% of Iranian patients referred to the Baqiyatallah hospital represented HA variation which must be considered in hepatic surgeries.

Patients’ knowledge and attitudes regarding human papillomavirus disease and the effectiveness of education in patients referred to the Dermatology Clinic of Baqiyatallah Hospital in 2020

"Introduction: Human papillomavirus infection considers one of the leading causes of infection-related cancer worldwide. The general public's range of knowledge and understanding of human papillomavirus is low; the present study was done intending to evaluate the knowledge and attitude of patients with human papillomavirus and the effectiveness of educational intervention in those patients. Methods: This was a quasi-experimental study. The study population included patients with genital human papillomavirus referred to Dermatology Clinic of Baqiyatallah Hospital in 2020. The patients filled out a pre-test questionnaire. In the next step, they were trained by the treating physician about the disease, transmission ways, complications, treatment methods, and laboratory tests, and available vaccines. After that, an educational pamphlet was given to the patient to complete and review the information. Moreover, a post-test was performed in the patient's next visit. Data were analyzed using SPSS software version 22. Results: 92 patients were included in the study. The levels of knowledge and attitude of patients were between 50 to 65% before training and training had a significant impact on improving the level of knowledge and attitude of patients (P 0.001) so that the level of knowledge and attitude of patients reached above 95%. Demographic factors such as age, gender, marital status, and level of education were not related to the initial knowledge and attitude of individuals based on the statistical analysis (P 0.05). However, the knowledge of married people about the complications of the disease was more than single ones (P = 0.032). Conclusion: the level of knowledge about human papillomavirus and its complications, transmission ways, prevention and treatment is low, which has increased with training significantly "

Detecting of beta-lactamase genes in clinical isolates of Escherichia coli isolated from Baqiyatallah Hospital of Bashagard and evaluating their antibiotic resistance and biofilm formation

Biofilm formation has been observed in different species of bacteria such as Escherichia coli and Pseudomonas aeruginosa. The formation of biofilms in the airways of pneumonia patients and chronic lung patients is one of the important factors in prolonging the treatment period, exacerbating clinical symptoms and even death of patients. The present study aimed to investigate beta-lactamase genes in clinical isolates of Escherichia coli isolated from Baqiyatallah Bashagard Hospital and to evaluate their antibiotic resistance and biofilm formation. In the present study, 60 isolates from fecal samples of patients with symptoms of diarrhea and suspected Escherichia coli infection were collected and selected from Baqiyatallah Hospital of Bashagard. After confirmation of Escherichia coli strains using microbial culture and biochemical tests, the presence of three beta-lactamase genes in these isolates was examined. The ability of isolates to form biofilms and their resistance to two different antibiotics were also measured. A phenotypic study of isolates based on optical absorbance measurements showed that among the clinical Escherichia coli isolated from Baqiyatallah Hospital of Bashagard, only 10 isolates could form a strong biofilm in the microtiter plate.

Investigating the causes and rate of infant mortality of Baqiyatallah hospital from 2015 to 2020

Investigating the causes and rate of infant mortality of Baqiyatallah hospital from 2015 to 2020

On Therapeutic Plasma Exchange Against Severe COVID-19-Associated Pneumonia: An Observational Clinical Study.

BackgroundThere is a risk of novel mutations of SARS-CoV-2 that may render COVID-19 resistant to most of the therapies, including antiviral drugs and vaccines. The evidence around the application of therapeutic plasma exchange (TPE) for the management of critically ill patients with COVID-19 is still provisional, and further investigations are needed to confirm its eventual beneficial effects.AimsTo assess the effect of TPE on the risk of mortality in patients with COVID-19-associated pneumonia, using three statistical procedures to rule out any threats to validity.MethodsWe therefore carried out a single-centered retrospective observational non-placebo-controlled trial enrolling 73 inpatients from Baqiyatallah Hospital in Tehran (Iran) with the diagnosis of COVID-19-associated pneumonia confirmed by real-time polymerase chain reaction (RT-qPCR) on nasopharyngeal swabs and high-resolution computerized tomography chest scan. These patients were broken down into two groups: Group 1 (30 patients) receiving standard care (corticosteroids, ceftriaxone, azithromycin, pantoprazole, hydroxychloroquine, lopinavir/ritonavir), and Group 2 (43 patients) receiving the above regimen plus TPE (replacing 2 l of patients' plasma by a solution, 50% of normal plasma, and 50% of albumin at 5%) administered according to various time schedules. The follow-up time was 30 days and all-cause mortality was the endpoint.ResultsDeaths were 6 (14%) in Group 2 and 14 (47%) in Group 1. However, different harmful risk factors prevailed among patients not receiving TPE rather than being equally split between the intervention and control group. We used an algorithm of structural equation modeling (of STATA) to summarize a large pool of potential confounders into a single score (called with the descriptive name “severity”). Disease severity was lower (Wilkinson rank-sum test p < 0.001) among patients with COVID-19 undergoing TPE (median: −2.82; range: −5.18; 7.96) as compared to those not receiving TPE (median: −1.35; range: −3.89; 8.84), confirming that treatment assignment involved a selection bias of patients according to the severity of COVID-19 at hospital admission. The adjustment for confounding was carried out using severity as the covariate in Cox regression models. The univariate hazard ratio (HR) of 0.68 (95%CI: 0.26; 1.80; p = 0.441) for TPE turned to 1.19 (95%CI: 0.43; 3.29; p = 0.741) after adjusting for severity.ConclusionsIn this study sample, the lower mortality observed among patients receiving TPE was due to a lower severity of COVID-19 rather than the TPE effects.

A single-center non-blinded randomized clinical trial to assess the safety and effectiveness of PhR160 spray the treatment of COVID-19 pneumonia

COVID-19 is an emerging pandemic that caused a very widespread infection with more than 1000000 cases in Iran within a year. The main cause of mortality among patients with COVID-19 is pulmonary failure. In Iranian Traditional Medicine, essences have been used for curing pulmonary diseases. Pinen-Hydeonoplacton-Ribonucleic acid (PHR) is an inhaler spray made of seven different plants, which all are used by humans, have desirable pharmacological features for treating pulmonary symptoms of COVID-19 patients. This study was conducted to assess the safety and effectiveness of PHR160 spray in improving pulmonary symptoms of COVID-19 patients. This was a single-center, non-blinded randomized clinical trial with two parallel groups in two different wards of Baqiyatallah hospital, Tehran, Iran. Participants were 51 male patients, diagnosed with COVID-19 pneumonia, divided into 2 groups of 32 in the intervention group and 31 in the control group. The intervention group received 5 days of PHR160 spray, 10 puffs each day, 300 micrograms in each puff in addition to the routine treatment. Oxygen saturation was measured by a pulse oximeter, every 6 hours and recorded daily This study showed that the intervention increased significantly the arterial oxygen saturation percentage in COVID-19 patients. In addition, it decreases hospitalization duration, dyspnea score and cough score significantly in the patients. The statistical modeling test, with adjusting the age and respiratory rate for baseline and 4 days of the intervention, shows that the oxygen saturation percentage mean was significantly more in the intervention group by 5.14 units (p<0.001).