Imam Khomeini Hospital Research Articles

Impact of Medical Factors on Mortality in Patients With End-Stage Renal Disease in the West of Iran: A Prospective Study

Background and aims: End-stage renal disease (ESRD) is a pervasive global health challenge with high mortality rates. This prospective study aimed to identify medical factors influencing mortality in ESRD patients. Methods: Data from 149 ESRD patients registered at Imam Khomeini hospital in Kermanshah were analyzed. Only patients with a minimum of one-year follow-up were included. Univariate and multiple regression analyses were employed, and model evaluation utilized indicators such as the area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity. Results: Among 149 ESRD patients, 88 (59.1%) were male, and 37 (24.7%) experienced mortality. The average age of deceased patients was 63.59±15.74 years. Chronic glomerulonephritis was the underlying cause in 72 (48.3%) participants. Multiple regression revealed that age, diabetes, and a history of heart failure significantly correlated with mortality. ESRD patients with diabetes faced a 2.47-fold increased risk of death (95% confidence interval: 1.10 - 5.55). The model exhibited an area under the curve (AUC) of 0.70, with sensitivity and specificity of 51.35% and 75%, respectively. Conclusion: Given the chronic nature of ESRD and elevated mortality, particularly among diabetic patients, intensified monitoring efforts are crucial for the prevention and management of diabetes in this population.

Proposing new design and retrofitting objectives for seismic design of hospital structures: a case study of Imam Khomeini Hospital in Eslamabad-e Gharb

Proposing new design and retrofitting objectives for seismic design of hospital structures: a case study of Imam Khomeini Hospital in Eslamabad-e Gharb

Determining the Type and Frequency of Prescribed Antibiotics in Patients Admitted to the Infectious Department of Imam Khomeini Hospital in Jiroft, year 2021 (A Cross-Sectional Study)

Determining the Type and Frequency of Prescribed Antibiotics in Patients Admitted to the Infectious Department of Imam Khomeini Hospital in Jiroft, year 2021 (A Cross-Sectional Study)

Molecular characterization of Staphylococcus aureus isolated from hospital-acquired infections in Ilam, Iran.

This research study was undertaken to investigate antimicrobial resistance patterns and the prevalence of hospital-acquired infections (HAIs). The study focuses on common microorganisms responsible for HAIs and explores emerging challenges posed by antimicrobial drug-resistant isolates. A comprehensive analysis of 123 patients with HAIs, hospitalized in surgical department and intensive care unit (ICU) at Imam Khomeini Hospital, Ilam, Iran, was conducted over a six-month period. Pathogenic bacterial isolates, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Staphylococcus aureus (VRSA), were isolated and subjected to antibiotic susceptibility testing. The study findings revealed a significant prevalence of multidrug-resistant (MDR) isolates, of which 73.3% were MRSA. Notably, 6.7% of S. aureus isolates exhibited resistance to vancomycin, indicating the emergence of VRSA. Respiratory infections were identified as the most prevalent HAI, constituting 34.67% of cases, often arising from extended ICU stays and invasive surgical procedures. Furthermore, patients aged 60 and above, particularly those associated with MDR, exhibited higher vulnerability to HAI. This research sheds light on the intricate interplay between drug resistance and HAI, highlighting the imperative role of rational antibiotic use and infection control in addressing this critical healthcare challenge.

Comparison of Spectral and Temporal Processing Abilities between Adults with Stroke and Healthy Peers

Background and Aim: Perception of speech in noise (SIN) is based on the accurate extraction of spectral and temporal cues. Disruption of this process can reduce the productivity of the spectral and temporal features of the target stimulus and speech recognition in noise. Auditory processing disorder is one of the main challenges of people with stroke, which leads to social, mental, and even physical failures. This study aimed to investigate the spectral and temporal processing abilities of people with stroke compared to healthy peers. Methods: In this study, participants were 15 patients with stroke referred to the neurology clinic of Imam Khomeini Hospital and 30 healthy people aged 20–60 years. Spectral Modulation Detection Test (SMDT), Pitch Pattern Sequencing Test (PPST), Random Gap Detection Test (RGDT) and QuickSIN tests were performed for all participants. The mean scores of the two groups were compared. Results: Patients with stroke had poorer performance in SMDT, PPST, RGDT and QuickSIN tests (p<0.001) compared to healthy subjects. The results showed that there was a significant correlation between SIN test with temporal and spectral processing in the normal group, but the correlation pattern was different in people with stroke. The scores of all the tests were not significantly different between the right and left ears. Conclusion: The results showed that people with stroke have poorer performance in all tests compared to normal people and have more problems in speech perception in challenging areas. Keywords: Auditory processing disorder; speech perception in noise; spectral modulation; temporal processing; stroke

Mediating role of resilience in a relationship between social support and CD4 count of patients living with HIV in Behavioral Diseases Counseling Center of Imam Khomeini Hospital, Tehran

Mediating role of resilience in a relationship between social support and CD4 count of patients living with HIV in Behavioral Diseases Counseling Center of Imam Khomeini Hospital, Tehran

Comparative effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with diabetes in Tehran, Iran: utilization of message texting

Background and purposeProviding physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes.MethodsThis experimental study was conducted in 2022 with two intervention groups and one control group consisting of 129 patients with type 2 diabetes who were referred to Imam Khomeini Hospital in Tehran. Over the course of one month, each individual in intervention group 1 received 15 text messages focusing on physical health, while intervention group 2 received 15 psychological text messages related to the TRA. The control group did not receive any text messages during this period. The data collection tool used was the “Audit of Diabetes-Dependent Quality of Life (ADDQoL)” questionnaire, which was completed by the participants before and after the intervention. The data were analyzed using SPSS version 16 software at a statistical significance level of 0.05.ResultsIn the intervention-1 group, the average life quality score was 8.51 units (P < 0.001), while in the intervention-2 group, it was 19.25 units (P < 0.001) higher than the control group. The psychological training group had a 17.62 units (P < 0.05) lower average fasting blood sugar (FBS) and a 10.74 units (P < 0.001) higher average quality of life compared to the physical training group.ConclusionThe results of this study showed that the effectiveness of psychological training of the TRA model in improving life quality and reducing FBS in patients with diabetes is greater than physical health training. It is suggested that policy makers and health managers base future plans on physical health promotion training along with TRA model mental health training for the development of education in patients with diabetes. Specialists and healthcare workers can also act to improve personal health characteristics, especially those related to reducing FBS and increasing the quality of life of patients with diabetes, by using training through mobile phone text messages, particularly with psychological content TRA based.

A comprehensive protocol for evaluating health, safety, and environmental risks of hospital solid waste through FMEA technique

This protocol outlines a comprehensive approach to evaluating hospital solid waste levels and assessing associated health, safety, and environmental (HSE) risks using the Failure Mode and Effects Analysis (FMEA) methodology. The study focuses on Imam Khomeini Hospital (RA) and employs both quantitative and qualitative methods. Over a 3-month period, waste production and potential risks are assessed, with specific attention to household, infectious, medicinal, and sharps waste. Through FMEA, potential failure modes and associated risks in waste management sectors are identified, enabling targeted interventions for risk mitigation. The protocol emphasizes the importance of aligning waste management practices with international standards and highlights the need for comprehensive training, awareness campaigns, and effective waste management methods to ensure the safety and environmental responsibility of hospital waste management practices

Long-term survival after hepatic resection for colorectal liver metastases: a single-center study in Iran

BackgroundSurgical resection of colorectal cancer liver metastasis (CRLM) has been associated with improved survival in these patients. The purpose of this study was to investigate the usefulness of liver metastasectomy, also finding independent factors related to survival after liver metastasectomy.MethodsIn a retrospective study, all patients with CRLM who underwent resection of liver metastases between 2012 and 2022 at Imam Khomeini Hospital Complex in Tehran, Iran, were enrolled. All patients were actively followed based on clinicopathologic and operative data.ResultsA total of 248 patients with a median follow-up time of 46 months (Range, 12 to 122) were studied. Eighty-six patients (35.0%) underwent major hepatectomy, whereas 160 (65.0%) underwent minor hepatectomy. The median overall survival was 43 months (Range, 0 to 122 months), with estimated 1-, 3- and 5-year overall survival rates of 91%, 56%, and 42%, respectively. Multivariate analysis demonstrated that a metastasis size > 6 cm, major hepatectomy, rectum as the primary tumor site, and involved margin (< 1 mm) were independent factors associated with decreased overall survival (OS).ConclusionSurgical resection is an effective treatment for patients with CRLM that is associated with relatively favorable survival. A negative margin of 1 mm seems to be sufficient for oncological resection.

Comparison of Intralesional Vitamin D with Intralesional Triamcinolone Acetonide in the Treatment of Keloids.

Hypertrophic scars and keloids are disorders caused by the excessive growth of connective tissue, associated with the accumulation of collagen and cellular matrix components. These scars are caused by abnormal wound healing and can have a great impact on patients' lives. Therefore, we aimed to compare the effect of intralesional injection of vitamin D with triamcinolone acetonide in the treatment of keloid. This study was a one-sided blind clinical trial, conducted on 22 patients (44 samples) with keloid. It was a randomized, blinded clinical trial, conducted in Imam Khomeini Hospital in Ahvaz, Iran in 2022. In each group, triamcinolone or vitamin D was injected at the lesion site with an interval of three weeks and an average of 6 sessions. The patients were re-evaluated 3 months after the end of the treatment in terms of recurrence. By examining the VSS scale in each of the groups, this scale decreased significantly in both groups after the intervention (P=0.001), which was greater in the group receiving triamcinolone (P=0.001). It seems that the injection of vitamin D at the site of the lesion helps to treat it, but the effectiveness of the usual triamcinolone treatment was still higher, it is suggested to use vitamin D as an adjunctive treatment in these patients.

Comparison of the effect of intra-dermal injection of botulinum toxin and normal saline in the treatment of facial skin pores.

Skin pores (SPs) are normal and benign skin structures that are mostly located on the face (nose, cheeks, etc.) that cause many aesthetic concerns or complaints. One known effective treatment is botulinum toxin A (BTXA), which is also approved for the treatment of strabismus, blepharospasm, muscle spasm, cervical dystonia, glabella wrinkles, and primary axillary hyperhidrosis. Therefore, the aim of this study was to compare the effect of intra-dermal injection of botulinum toxin and normal saline serum (NSS) in the treatment of large facial pores. The study included 25 people who referred to the skin clinic of Imam Khomeini Hospital in Ahvaz from June 2021 to January 2022 for the treatment of large facial skin pores. Randomly, some subjects were injected with botulinum toxin at ten points, and each point was equivalent to 2.5 units of Masport (500 units vial of Masport diluted with 10 ml of NSS). Some other people were injected with 0.05 ml of NSS by intra-dermal injection at ten points. Finally, the data were analyzed using SPSS-Ver. 22 software. Based on optical coherence tomography results, it was determined that the diameter of facial pores decreased significantly (P = 0.011). Dermoscopy showed a significant decrease in the average size of facial pores (P < 0.011), and also, the pore score decreased significantly (P = 0.021). In addition, the results showed that the size of skin pores and facial fat on both sides of the face did not decrease significantly from the patients' point of view (P = 0.71). Based on the results of the present study, it can be concluded that intra-dermal injection of botulinum toxin is an effective and safe method to control facial pores, which showed acceptable results after 3 months.

Evaluating the Relationship between Various Risk Factors and COVID-19 Incidence in People Living with HIV: A Cross-Sectional Study.

People living with HIV (PLWH) are more susceptible to acquiring and having serious consequences from COVID-19. The objective of this study was to examine the correlation between COVID-19 infection and other risk factors in these patients. This is a descriptive-analytical study recruiting 160 PLWH referred to the Behavioral Disease Counselling Centre of Imam Khomeini Hospital in Tehran in 2021. The patients were selected through convenient sampling. A checklist was used to collect the necessary data. Descriptive statistical tests, such as mean and standard deviation, were employed alongside inferential statistics, including chi-square, Fisher, independent t-tests, and logistic regression, all evaluated at a significance level of p<0.05 using the R software. The patients' average age was 43.15 ± 11.23. Forty-four women and 116 men were present. A notable association was observed between the incidence of COVID-19 and variables such as hepatitis C and the duration of time since HIV diagnosis (p<0.001). Moreover, a strong correlation was found between the amount of COVID-19 vaccination doses given to patients and their probability of acquiring the disease. The first vaccination dose was linked to a 5.45 percent increase in COVID-19 incidence in patients, whereas the second and third doses (t=2.95, t=7.57) reduced the risk of getting COVID-19. Furthermore, no discernible link (p>0.05) was found between the use of various antiretroviral medications and COVID-19 infection. This study finds that vaccine type does not impact COVID-19 outcomes in HIV-positive patients, but receiving more doses decreases the probability of occurrence of COVID-19, advocating for multiple vaccinations. However, PLWH, especially those non-compliant with antiretrovirals, need strict adherence to health protocols due to heightened vulnerability to viral illnesses.

Safety and effectiveness of single- versus double-dose of seasonal influenza vaccine in kidney transplant recipients: a randomized clinical trial

Introduction. Influenza virus poses significant risks to immunocompromised individuals such as those who have received organ transplants and are undergoing immunosuppressive treatment to prevent transplant rejection. Therefore, annual influenza vaccination is recommended for these individuals. This study aimed to comparison of safety and effectiveness of single- versus double-dose of seasonal influenza vaccine in kidney transplant recipients. Materials and methods. This randomized clinical trial involved 50 kidney transplant recipients at Imam Khomeini Hospital. Participants were randomly assigned to two groups: those receiving a single dose (standard dose) and those receiving a double dose of the seasonal flu vaccine. Serum samples were collected before and 4 weeks after vaccination to measure influenza AB-related antibodies. Sixteen patients were excluded from the study. The trial focused on evaluating the vaccine safety and immunogenicity, as well as documenting any local and systemic side effects following vaccination. Results. The results indicated no significant difference in gender, age, and type of immunosuppressive drug used between the single- and double-dose groups (p 0.05). No significant difference in post-vaccination adverse effects, such as injection site pain (p = 0.21) between the two groups. The seroconversion rates (change from IgG 9 IU/µL to IgG 11 IU/µL) for IgG Influenza A were 12.5% (n = 2) in the single-dose group and 26.7% (n = 4) in the double-dose group, and for IgG Influenza B, they were 11.8% (n = 2) and 21.4% (n = 3), respectively. Conclusion. A double dose of the influenza vaccine slightly enhanced the immune response in kidney transplant patients without causing any adverse side effects.

Evaluation of the Effect of Neurofeedback on Polysomnographic Changes and Improvement in the Life Quality of People with HIV with Sleep Disorders: A Clinical Trial Study

Introduction Sleep disorders are considered as one of the most common illnesses among people with HIV. Due to this, using neurofeedback devices to alter brain waves is implemented as a complementary therapy. The aim of this study was to evaluate the effectiveness of neurofeedback on changes in interrupted sleep, duration of sleep, restless legs syndrome, and improve the quality of life in people with HIV with sleep difficulties. Methods The current study is a clinical trial and applied type of research in which the pre-test and post-test of two interventional and placebo groups were compared. The statistical population of all patients referred to the HIV Research Center of Imam Khomeini Hospital Complex was selected randomly. In this respect, 15 volunteer patients (9 volunteers in the treatment group and 6 volunteers in the placebo group) were chosen and placed into groups via random sampling. In addition, the Pittsburg Sleep Quality Index (PSQI) was used for the evaluation of sleep quality. Data were analyzed after statistical analysis through standard tests. Results The results of this study showed that neurofeedback was able to cause significant changes in reducing stress levels. This treatment was able to improve the quality of life indicators in participants. Also, there were changes in polysomnographic data; however, they were not significant. Conclusion Based on these data, Neurofeedback therapy could be considered a complementary therapy to improve sleep disorders in people with HIV.Moreover, this treatment was able to improve the quality of life and stress indicators in these patients by improving brain waves. Clinical Trial Registration No IR.TUMS.VCR.REC.1398.998.

Does Near Miss Compromise Sexual Function in Reproductive-Aged Women? A Comparative Cross-Sectional Study in Ahvaz, Iran

Background: Maternal near miss (MNM) is defined as any life-threatening event during pregnancy, delivery, or within six weeks after the termination of pregnancy. Objectives: This cross-sectional study aimed to assess sexual function in women with (n = 140) and without MNM (n = 246). Methods: Eligible participants were women with MNM and basic literacy who had given birth at least 8 - 12 weeks prior to the study. Participants were recruited from Imam Khomeini and Taleghani hospitals, while women without MNM were recruited from two public health centers in Ahvaz. Data collection commenced in December 2020 and concluded in March 2021. A demographic questionnaire and the Female Sexual Function Index were used to collect the data. Data were analyzed using independent t-tests, chi-square tests, and multiple linear regression. Results: The predominant mode of delivery among MNM women was cesarean section (70%, P &lt; 0.05). The most common causes of MNM were preeclampsia (41.43%) and placenta accreta (24.29%), followed by hypertension and diabetes (17.86%). Women without MNM reported significantly higher scores in sexual satisfaction (β = 0.355, 95% CI: 0.019, 0.690, P = 0.035), lubrication (β = 0.707, 95% CI: 0.435, 0.980, P &lt; 0.0001), sexual arousal (β = 0.394, 95% CI: 0.116, 0.522, P = 0.007), sexual desire (β = 0.319, 95% CI: 0.116, 0.522, p = 0.002), and total sexual function score (β = 1.768, 95% CI: 0.306, 3.230, P = 0.018). Women who had undergone cesarean section reported lower scores in sexual satisfaction (β = -0.646, 95% CI: -0.983, -0.309, P &lt; 0.0001), orgasm (β = -0.620, 95% CI: -0.965, -0.275, P &lt; 0.0001), sexual arousal (β = -0.473, 95% CI: 0.159, 0.439, P = 0.001), and total sexual function score (β = -3.181, 95% CI: -4.655, -1.707, P &lt; 0.0001). Older women scored significantly lower in all components of sexual function except for pain. Conclusions: The study results indicated that all components of sexual function, except pain, were lower in women with MNM. A significantly higher number of women who had undergone cesarean section experienced MNM and sexual dysfunction. Health policymakers should focus not only on the causes of MNM, particularly cesarean sections, but also on assessing the sexual function of women affected by MNM.

The Accuracy of the S100B Protein Biomarker in the Prognosis of Patients with Acute Spinal Cord Injury

Abstract Introduction The role of some biomarkers such as S100 beta (S100B) has been somewhat known in determining the severity of primary acute spinal cord injury (SCI), and today, it has been the basis of various relevant studies. Therefore, this study estimates the S100B level in serum and cerebrospinal fluid (CSF) in patients with spinal injuries. Methods This was a descriptive-analytic study. In this study, 31 patients with acute SCI referred to Sari Imam Khomeini Hospital, Iran, were recruited. Patients were divided into two groups of complete and incomplete SCI according to the American Spinal Injury Association (ASIA). The S100B concentrations in serum and CSF levels were compared between the two groups. Result There was only significant positive correlation between S100B CSF concentration and complete SCI based on the ASIA criterion, meaning that in cases of complete SCI the S100B CSF concentration was significantly increased correlation coefficient (CC) (cc = 0.529 and p = 0.002). Based on the results of serum S100B protein concentration, 14.70 ng/dL with a sensitivity of 66.7% and specificity of 55% was determined as cutoff for complete SCI. Also, about the CSF S100B protein level variable, concentration of 342.18 ng/dL with 100% sensitivity and 64% specificity was determined as cutoff for complete injury. Conclusion The results of this unique study have shown that S100B were useful markers for predicting the prognosis of patients with acute SCI and cutoff points determined for serum and especially CSF concentrations can differentiate complete and incomplete SCI.

Antibody Response Before and After the Booster Dose of Inactivated Corona Vaccine in Antibody Deficient Patients.

Patients with inborn errors of immunity (IEI) are among the high-risk groups regarding COVID-19. Receiving booster doses (third and fourth) in addition to the standard doses is recommended in these patients. This study investigated the antibody response before and after a booster dose of Sinopharm vaccine in IEI patients. Thirty patients (>12 years) with antibody deficiencies, referred to Imam Khomeini Hospital and Children's Medical Center in Tehran, were enrolled in this prospective cross-sectional study. All patients were fully vaccinated with the BBIBP-CorV vaccine (2 doses of Sinopharm). Initial measurements of anti-receptor-binding domain (anti-RBD) and anti-nucleocapsid (anti-N) IgG antibody responses were conducted by enzyme-linked immunosorbent assay (ELISA). Subsequently, all patients received a booster dose of the vaccine. Four to six weeks after booster injection, the levels of antibodies were re-evaluated. Twenty patients with common variable immunodeficiency (CVID), 7 cases with agammaglobulinemia and 3 patients with hyper IgM syndrome were studied. Anti-RBD IgG and anti-N IgG antibodies increased in all patients after the booster. Our results indicated the need of receiving booster doses of the COVID-19 vaccine in patients with antibody deficiencies, even for enhancing humoral immune response specially in patients with CVID.

Influential factors for final neurorehabilitation outcome scores in patients with spinal cord injury: A longitudinal cohort study

Study designLongitudinal prospective cohort study. ObjectivesTo assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure III (SCIM-III) scores over time in traumatic spinal cord injury (TSCI) patients. SettingPatient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center in Imam Khomeini Hospital Complex, Tehran, Iran. MethodsThe study was performed over an 8-year period in our outpatient rehabilitation setting. Changes in SCIM-III scores were assessed in 559 TSCI patients (of 1460 enrolled patients) who fit the inclusion criteria. All included patients participated in our outpatient rehabilitation program, which consisted of a multidisciplinary education program combined with occupational therapy, physical therapy, and home nursing as a rehabilitation package for a 6-month period. Patients then received follow-up assessments every 6 months. ResultsPredictors of the SCIM-III score as a rehabilitation outcome tool, and of its change over time, included age (younger patients had better outcomes, p = 0.067), marital status (married patients had better outcomes, p = 0.031), education level (patients with university education had better outcomes, p = 0.003), occupation status (employed patients had better outcomes, p = 0.009), and neurological level of injury (patients with injuries at lower levels had better outcomes, p < 0.001). However, sex and injury severity as per the American Spinal Injury Association Impairment Scale (AIS) had no significant effects on functional outcomes (i.e., SCIM-III score changes over time). ConclusionAge, marital status, education level, employment, and neurological level all affected the final SCIM-III scores of SCI patients. By contrast, sex and AIS grade were not significant predictors of SCIM-III outcomes. Further studies that include additional factors may be useful for future SCIM-III models.

A placebo-controlled, crossover trial to investigate the efficacy of tiotropium bromide or placebo added to usual care in stable symptomatic post-hematopoietic stem cell transplantation (HSCT) bronchiolitis obliterans syndrome (BOS)

BackgroundDespite the fundamental progress in hematopoietic stem cell transplant, this treatment is also associated with complications. Graft-versus-host disease is a possible complication of HSCT. Bronchiolitis obliterans syndrome (BOS) is the pulmonary form of this syndrome. Due to the high morbidity and mortality rate of BOS, various studies have been conducted in the field of drug therapy for this syndrome, although no standard treatment has yet been proposed. According to the hypotheses about the similarities between BOS and chronic obstructive pulmonary disease, the idea of using tiotropium bromide as a bronchodilator has been proposed.Method/designA randomized, double-blind, placebo-controlled, and crossover clinical trial is being conducted to evaluate the efficacy of tiotropium in patients with BOS. A total of 20 patients with BOS were randomly assigned (1:1) to receive a once-daily inhaled capsule of either tiotropium bromide (KP-Tiova Rotacaps 18 mcg, Cipla, India) or placebo for 1 month. Patients will receive tiotropium bromide or placebo Revolizer added to usual standard care. Measurements will include spirometry and a 6-min walking test.Ethics/disseminationThis study was approved by the Research Ethics Committees of Imam Khomeini Hospital Complex, Tehran University of Medical Science. Recruitment started in September 2022, with 20 patients randomized. The treatment follow-up of participants with tiotropium is currently ongoing and is due to finish in April 2024. The authors will disseminate the findings in peer-reviewed publications, conferences, and seminar presentations.Trial registrationIranian Registry of Clinical Trial (IRCT) IRCT20200415047080N3. Registered on 2022–07-12, 1401/04/21.

Skin Manifestations in Patients with COVID-19 Disease Admitted to the Corona Ward of Imam Khomeini Hospital in Ardabil City

Skin Manifestations in Patients with COVID-19 Disease Admitted to the Corona Ward of Imam Khomeini Hospital in Ardabil City